Air Force HPSP - Should I Do It?

[beepboop39]

Hi everyone! I am pre-med and will matriculate this fall 2023. I have applied for the Air Force HPSP and am set to attend MEPS next week. As the official commitment gets closer, I am getting nervous about making such a huge commitment. I am looking for honest and thoughtful guidance on HPSP and if it's the right choice for me. What follows is a long post detailing my reasons for wanting to do it and also my concerns. Thank you in advance for reading and responding with kindness and honesty!

A little about me: I am a non-traditional student (29F) changing careers with a background in youth development nonprofit orgs. I have no prior military service. I have a few family members who have served or are serving but I wouldn't call us a "military family." My main specialty of interest is psychiatry, but I'm also interested in family medicine and maybe OB/GYN. I'm pretty set on psychiatry but also know that there's a chance of this changing as I learn more during medical school.

Initially, I was attracted to HPSP for the financial benefits. Although I'm not in dire need of financial support (my fiance makes enough to pay for our living expenses and if I don't do HPSP I will take out loans for just the cost of tuition), medical school is expensive. I like the idea of receiving the stipend so that I can contribute to covering our living expenses while I'm in school. We are also looking to buy a house and the $20k signing bonus would set us up nicely to make a sizable down payment. I also doubt that I will go into a super high-paying specialty, so the argument that, in the long run, HPSP doesn't actually benefit you financially doesn't apply to me (I think - open to feedback on this).

As far as pro's of being an actual military doctor go - as someone who is interested in psychiatry, I know there's a huge need for mental health support in the military and I'm excited about providing care for this demographic. I'm also very passionate about physical fitness and I know that during active duty time, you're held to the Air Force's standards for physical fitness and that excites me.

Con's - There are a lot of areas that concern me. I've spoken to my recruiter about these concerns but I know that recruiters just want to get you to take the scholarship so I really just want honest feedback about these.

• Deployment - what does this actually look like for Air Force docs (psychiatry, family med, OB/GYN specifically)? I'm not opposed to going abroad but I am opposed to leaving my fiance for long periods of time. Will he get to come with me? If I have kids during my active duty time, will I have to leave them? How long are deployments?
• GMO stuff - I feel like I would be devastated if my residency was delayed by a GMO tour. Is not matching to a residency the only reason you'd have to do GMO? Or can the air force make you pause your residency and do a GMO tour if they need more GMOs?
• Residency placement - from my understanding, all the specialties I'm interested in are pretty needed, so I'm not too concerned about matching in psychiatry or family med... guess I'm just looking for affirmation here that this is not something to worry about. Also, do I have to go through the military match before applying to civilian residencies? Or can I skip the military match if I know I want to do a civilian residency? This is referred to as applying for a deferment, right?
• Quality of life - I've read a few things online that concern me about quality of life while you're working in a military hospital. What are the hours like? Is it true that military hospitals work you like a dog and don't give you the resources you need to do your job well? I'm generally just concerned about hating my life for 4-8 years while working in a military hospital. Would love to hear about personal experiences and/or the general consensus here.
• Career prospects post-military - I'm a little concerned about building my career post-military if all the connections I'm making over the years are in military medicine and I don't want to make a career in military medicine. Will I have trouble finding a job & building a career outside of the military after I leave the air force?
• Things I've heard - I've read a lot of feedback on SDN and elsewhere saying "if you don't want a career in military med, don't do HPSP" or "if you wouldn't go into the military without HPSP don't do it" or "if you aren't excited about dying for your country, don't do it"... my question is, why do people say this? Is it just because they're sick of people doing it for the money? Or is the experience so bad that the money isn't worth it? I want to be a physician to help sick people - if those sick people are in the military/military families for part of my career, what difference does it make? Please educate me.

If you've made it this far, thank you so much. Your feedback and opinions are so appreciated.

---

Members don't see this ad.

 

[DOswag]

Hi everyone! I am pre-med and will matriculate this fall 2023. I have applied for the Air Force HPSP and am set to attend MEPS next week. As the official commitment gets closer, I am getting nervous about making such a huge commitment. I am looking for honest and thoughtful guidance on HPSP and if it's the right choice for me. What follows is a long post detailing my reasons for wanting to do it and also my concerns. Thank you in advance for reading and responding with kindness and honesty!

A little about me: I am a non-traditional student (29F) changing careers with a background in youth development nonprofit orgs. I have no prior military service. I have a few family members who have served or are serving but I wouldn't call us a "military family." My main specialty of interest is psychiatry, but I'm also interested in family medicine and maybe OB/GYN. I'm pretty set on psychiatry but also know that there's a chance of this changing as I learn more during medical school.

Initially, I was attracted to HPSP for the financial benefits. Although I'm not in dire need of financial support (my fiance makes enough to pay for our living expenses and if I don't do HPSP I will take out loans for just the cost of tuition), medical school is expensive. I like the idea of receiving the stipend so that I can contribute to covering our living expenses while I'm in school. We are also looking to buy a house and the $20k signing bonus would set us up nicely to make a sizable down payment. I also doubt that I will go into a super high-paying specialty, so the argument that, in the long run, HPSP doesn't actually benefit you financially doesn't apply to me (I think - open to feedback on this).

As far as pro's of being an actual military doctor go - as someone who is interested in psychiatry, I know there's a huge need for mental health support in the military and I'm excited about providing care for this demographic. I'm also very passionate about physical fitness and I know that during active duty time, you're held to the Air Force's standards for physical fitness and that excites me.

Con's - There are a lot of areas that concern me. I've spoken to my recruiter about these concerns but I know that recruiters just want to get you to take the scholarship so I really just want honest feedback about these.

• Deployment - what does this actually look like for Air Force docs (psychiatry, family med, OB/GYN specifically)? I'm not opposed to going abroad but I am opposed to leaving my fiance for long periods of time. Will he get to come with me? If I have kids during my active duty time, will I have to leave them? How long are deployments?
• GMO stuff - I feel like I would be devastated if my residency was delayed by a GMO tour. Is not matching to a residency the only reason you'd have to do GMO? Or can the air force make you pause your residency and do a GMO tour if they need more GMOs?
• Residency placement - from my understanding, all the specialties I'm interested in are pretty needed, so I'm not too concerned about matching in psychiatry or family med... guess I'm just looking for affirmation here that this is not something to worry about. Also, do I have to go through the military match before applying to civilian residencies? Or can I skip the military match if I know I want to do a civilian residency? This is referred to as applying for a deferment, right?
• Quality of life - I've read a few things online that concern me about quality of life while you're working in a military hospital. What are the hours like? Is it true that military hospitals work you like a dog and don't give you the resources you need to do your job well? I'm generally just concerned about hating my life for 4-8 years while working in a military hospital. Would love to hear about personal experiences and/or the general consensus here.
• Career prospects post-military - I'm a little concerned about building my career post-military if all the connections I'm making over the years are in military medicine and I don't want to make a career in military medicine. Will I have trouble finding a job & building a career outside of the military after I leave the air force?
• Things I've heard - I've read a lot of feedback on SDN and elsewhere saying "if you don't want a career in military med, don't do HPSP" or "if you wouldn't go into the military without HPSP don't do it" or "if you aren't excited about dying for your country, don't do it"... my question is, why do people say this? Is it just because they're sick of people doing it for the money? Or is the experience so bad that the money isn't worth it? I want to be a physician to help sick people - if those sick people are in the military/military families for part of my career, what difference does it make? Please educate me.

If you've made it this far, thank you so much. Your feedback and opinions are so appreciated.

Air Force psychiatrist here, did the HPSP route. I'll try to answer these as best I can from my perspective. From your pro list, there's a huge need for mental health providers everywhere. You can work for the VA and make good money with good benefits if you want to work with people who have served in the military. Yes the military has fitness standards but I wouldn't really place that on my list of things that would make me want to sign up for the military. You can be as fit as you want in or outside the military. Currently it feels like just one more thing that's required of me and if you fail a fitness test, that can start to cause problems for you. It's really not that hard to pass a fitness test though.

Deployment- I am coming to the end of my 4 year payback and have not deployed. Last I heard there was currently only one spot where Air Force psychiatrist were being deployed to and it was Guantanamo Bay. This has not always been the case as I know prior service docs who were deployed to other places. This also is likely to change in the future especially in light of what's happening in the world. No way to know what the deployment cycles will look like 8 years from now. I can't speak to family med or OB/GYN in regards to deployment. Going abroad is not the same thing as deploying though. You can be stationed overseas and your family can accompany you in that instance. Deployment you will be separated from your spouse and kids. Air Force deployments typically 6 months.

GMO stuff- I did not match to a residency spot my first go around (applied EM and did not match in the mil match). If that happens you will be able to complete an intern year (surgical, internal med, or transitional). I was deferred to a civ intern year and completed a traditional rotating internship. I reapplied psychiatry and matched (very glad I switched from EM to psych lol). I know people who did their intern year and then went into flight medicine as a flight surgeon. It's not for everyone but if you are planning to reapply and stay in the military, spending time as a flight doc can help in the mil match as they have a point system that rewards that kind of stuff. Helps if you're planning on going into something more competitive. The Air Force does not take you out of residency to put you in a GMO spot. You may have to do something like GMO/FS if you don't match the 2nd go around. You have to complete 1 year of training (the intern year) to be able to practice medicine though.

Residency placement-Going through the match will be stressful. The military match typically has less spots in whatever specialty compared to civilian side so there's still the possibility of not matching into something. Typically family med is less competitive, I'm not sure about how competitive OB/GYN is, but psychiatry has been trending toward being more competitive in the last few years though. Not saying this to scare you just don't take it lightly. If I remember correctly you have to go through the mil match but you get to rank if you prefer civ deferred as your first choice then rank order the mil programs. For psych there are only 2 Air Force residency programs and that is one in San Antonio through UT Health/BAMC or one in Dayton OH through Wright St. Both are combined mil/civ programs so you'll split time between civilian sites and military sites. Just recently heard for psych they are doing away with civ deferred spots though. Perk to being a military resident, you get paid quite a bit more than civ counterparts. But they make up for it on the other side because you won't get paid as much as an attending/staff psychiatrist in the military.

Quality of Life-Now as a staff psychiatrist, I don't work in the hospital, straight outpatient. We had to do plenty of rotations in the hospital in residency and many rotations were at a military hospital. Other than mostly the patient population being different, the work itself wasn't really different than the civ side. Residency is going to suck to some extent no matter where you go or what specialty you choose. Generally psych residencies aren't nearly as grueling as say IM or gen surg. My most intense rotations in residency hour-wise were internal med we had to do intern year. Most of my psych rotations in the hospital were 7ish in the morning to 5-530ish in the evening. I'd typically get there a little earlier to review patients but not as bad as IM residents. 3rd year is straight outpatient clinic with decent hours (except for taking call shifts). Quality of life after residency is better but as stated above, you'll make less than your civilian counterparts and depending on what specialty you choose, that could be significantly less. In military you get paid based on you rank and time in service plus a bonus for your specialty. Specialist get a higher bonus than primary care does. But if you find that you really want to do orthopedic surgery, a military orthopod is giving up hundreds of thousands of $$ per year compared to being a civilian orthopod. Primary care isn't quite as big of a gap but still you would make more as a civilian.

Career prospects post-military-Extremely unlikely that you'll have any problems finding a job post-military. When I started looking for jobs, I got multiple interviews and the interviews were different than ones you experience for med school/residency where you are basically trying to convince them you'd be a good match for their school/residency program. Jobs were basically trying to sell me why I should come there to be a psychiatrist. It felt great to be honest lol. As a physician, you'll be sought after. I get calls now about positions open looking to hire psychiatrist but I've already signed a contract. Get emails too about open positions. You'll be fine post-military as far as finding a job.

Things I've heard-I am a proponent of all those things you've heard. Not at all because I'm tired of people doing it for the money. It's more that I don't think financially it justifies what you have to put up with being a physician in the military and I think people just look at the financial aspect of having your school paid for and think it's worth putting up with several years in the military (basically the way I looked at it all those years ago). If I had it to do over again, very unlikely I'd pick HPSP again. Lots of administrative BS that the military requires of you. Lots of extra meetings that feel like a huuuuuge waste of time. The ever increasing demand of your productivity while also adding BS administrative tasks to you while decreasing manning. The altruistic motivation you have as a bright eyed premed soon to be med student will be put to the test over the next almost decade (or longer if you decide to go military).

I love being a psychiatrist, just not being one in the military. Feels like you do more occupational med because you are constantly having to be aware of “should this patient be in the military”. There are times when due to mental health, you have to be the one to decide if the person has a condition that is unfitting or unsuiting and likely should not be in the military. Sometimes the patients are fine with that other times they are not and it can damage the treatment/rapport/relationship you have with the patient.

 

[beepboop39]

Air Force psychiatrist here, did the HPSP route. I'll try to answer these as best I can from my perspective. From your pro list, there's a huge need for mental health providers everywhere. You can work for the VA and make good money with good benefits if you want to work with people who have served in the military. Yes the military has fitness standards but I wouldn't really place that on my list of things that would make me want to sign up for the military. You can be as fit as you want in or outside the military. Currently it feels like just one more thing that's required of me and if you fail a fitness test, that can start to cause problems for you. It's really not that hard to pass a fitness test though.

Deployment- I am coming to the end of my 4 year payback and have not deployed. Last I heard there was currently only one spot where Air Force psychiatrist were being deployed to and it was Guantanamo Bay. This has not always been the case as I know prior service docs who were deployed to other places. This also is likely to change in the future especially in light of what's happening in the world. No way to know what the deployment cycles will look like 8 years from now. I can't speak to family med or OB/GYN in regards to deployment. Going abroad is not the same thing as deploying though. You can be stationed overseas and your family can accompany you in that instance. Deployment you will be separated from your spouse and kids. Air Force deployments typically 6 months.

GMO stuff- I did not match to a residency spot my first go around (applied EM and did not match in the mil match). If that happens you will be able to complete an intern year (surgical, internal med, or transitional). I was deferred to a civ intern year and completed a traditional rotating internship. I reapplied psychiatry and matched (very glad I switched from EM to psych lol). I know people who did their intern year and then went into flight medicine as a flight surgeon. It's not for everyone but if you are planning to reapply and stay in the military, spending time as a flight doc can help in the mil match as they have a point system that rewards that kind of stuff. Helps if you're planning on going into something more competitive. The Air Force does not take you out of residency to put you in a GMO spot. You may have to do something like GMO/FS if you don't match the 2nd go around. You have to complete 1 year of training (the intern year) to be able to practice medicine though.

Residency placement-Going through the match will be stressful. The military match typically has less spots in whatever specialty compared to civilian side so there's still the possibility of not matching into something. Typically family med is less competitive, I'm not sure about how competitive OB/GYN is, but psychiatry has been trending toward being more competitive in the last few years though. Not saying this to scare you just don't take it lightly. If I remember correctly you have to go through the mil match but you get to rank if you prefer civ deferred as your first choice then rank order the mil programs. For psych there are only 2 Air Force residency programs and that is one in San Antonio through UT Health/BAMC or one in Dayton OH through Wright St. Both are combined mil/civ programs so you'll split time between civilian sites and military sites. Just recently heard for psych they are doing away with civ deferred spots though. Perk to being a military resident, you get paid quite a bit more than civ counterparts. But they make up for it on the other side because you won't get paid as much as an attending/staff psychiatrist in the military.

Quality of Life-Now as a staff psychiatrist, I don't work in the hospital, straight outpatient. We had to do plenty of rotations in the hospital in residency and many rotations were at a military hospital. Other than mostly the patient population being different, the work itself wasn't really different than the civ side. Residency is going to suck to some extent no matter where you go or what specialty you choose. Generally psych residencies aren't nearly as grueling as say IM or gen surg. My most intense rotations in residency hour-wise were internal med we had to do intern year. Most of my psych rotations in the hospital were 7ish in the morning to 5-530ish in the evening. I'd typically get there a little earlier to review patients but not as bad as IM residents. 3rd year is straight outpatient clinic with decent hours (except for taking call shifts). Quality of life after residency is better but as stated above, you'll make less than your civilian counterparts and depending on what specialty you choose, that could be significantly less. In military you get paid based on you rank and time in service plus a bonus for your specialty. Specialist get a higher bonus than primary care does. But if you find that you really want to do orthopedic surgery, a military orthopod is giving up hundreds of thousands of $$ per year compared to being a civilian orthopod. Primary care isn't quite as big of a gap but still you would make more as a civilian.

Career prospects post-military-Extremely unlikely that you'll have any problems finding a job post-military. When I started looking for jobs, I got multiple interviews and the interviews were different than ones you experience for med school/residency where you are basically trying to convince them you'd be a good match for their school/residency program. Jobs were basically trying to sell me why I should come there to be a psychiatrist. It felt great to be honest lol. As a physician, you'll be sought after. I get calls now about positions open looking to hire psychiatrist but I've already signed a contract. Get emails too about open positions. You'll be fine post-military as far as finding a job.

Things I've heard-I am a proponent of all those things you've heard. Not at all because I'm tired of people doing it for the money. It's more that I don't think financially it justifies what you have to put up with being a physician in the military and I think people just look at the financial aspect of having your school paid for and think it's worth putting up with several years in the military (basically the way I looked at it all those years ago). If I had it to do over again, very unlikely I'd pick HPSP again. Lots of administrative BS that the military requires of you. Lots of extra meetings that feel like a huuuuuge waste of time. The ever increasing demand of your productivity while also adding BS administrative tasks to you while decreasing manning. The altruistic motivation you have as a bright eyed premed soon to be med student will be put to the test over the next almost decade (or longer if you decide to go military).

I love being a psychiatrist, just not being one in the military. Feels like you do more occupational med because you are constantly having to be aware of “should this patient be in the military”. There are times when due to mental health, you have to be the one to decide if the person has a condition that is unfitting or unsuiting and likely should not be in the military. Sometimes the patients are fine with that other times they are not and it can damage the treatment/rapport/relationship you have with the patient.

Thank you SO much for this thoughtful and honest response! I really appreciate it and it gives me more to think about. I May pm you with questions. Thank you!!

 

[el mero mero]

From your writing, I believe you would be better served through the reserve. You'd get to serve but the service wouldn't dictate specialty. You can't join the reserves until during or after residency. The reserve offers pretty good loan repayment. The VA offers loan repayment as well and is always hurting for psych. VA careers pair well with the reserve. Reserve would meet the pros you listed while avoiding many of the cons.

 

[SirGecko]

Like DOswag said above, deployment and getting stationed overseas are two different things. (Definitely can’t bring your family on deployment) One thing to remember about getting stationed overseas is that while you can bring your dependents your spouse may have a hard time actually working for the 2-3 years you are overseas. Maybe they don’t care or were planning on writing their job anyway, I dunno. This is a pretty big issue though for a lot of families. Even in the states moving every three years is hard in a professional spouse but overseas it can actually be impossible.

Also for the match you have to apply through match first and you should assume they will make you train in the military residencies if there is a spot available.

 

[DMBandFan86]

I have applied for the Air Force HPSP and am set to attend MEPS next week. As the official commitment gets closer, I am getting nervous about making such a huge commitment.

Sounds like you are getting cold feet. From your post, you never posted a compelling reason to join. Your best listed reason for joining is monetary, and then you state that you really don't need it. So that's why you are getting cold feet, because you aren't convinced you want to serve.

I'm also very passionate about physical fitness and I know that during active duty time, you're held to the Air Force's standards for physical fitness and that excites me.

Thats sort of an odd take on PT. If you need something like the Air Force to keep you in fitness (and you're apparently also passionate about), then you likely will have trouble keeping in standards. It's all about your personal goals and ability to keep fitness. That has nothing to do with the military. I also agree with the above comment, the military standards are not hard to meet.

• Deployment - I'm not opposed to going abroad but I am opposed to leaving my fiance for long periods of time. Will he get to come with me? If I have kids during my active duty time, will I have to leave them? How long are deployments?

These are things you should have decided upon before starting your application. I am having a hard time understanding what you are joining for. It will be 8+ years until you can practice medicine. There is no way to predict what the global geopolitical climate and war-time experience will be at that time. Joining the military and not being okay with deployments, possible separations from family, etc is not a good idea. You're setting yourself up for failure. As you will have little-to-no control of such things when the time comes.

GMO stuff - I feel like I would be devastated if my residency was delayed by a GMO tour.

Another reason not to join in your case.

• Quality of life - I'm generally just concerned about hating my life for 4-8 years while working in a military hospital. Would love to hear about personal experiences and/or the general consensus here.

Yes, that is a possibility. There are people that love the military and people that hate it. You haven't listed a strong desire to wear the uniform and do day-to-day military things. Which is also a big part of serving. I am under the impression that you likely will not like it.

• Things I've heard - I've read a lot of feedback on SDN and elsewhere saying "if you don't want a career in military med, don't do HPSP" or "if you wouldn't go into the military without HPSP don't do it" or "if you aren't excited about dying for your country, don't do it"... my question is, why do people say this? Is it just because they're sick of people doing it for the money? Or is the experience so bad that the money isn't worth it?

You're probably not going to die for your country. But you should consider it a possibility. You haven't listed any military ambitions or reasons you really want to join. The military is for taking orders and executing orders. During the process you will collect rank and move up the ladder. As you move up the rank ladder you will do more administrative things and go to more officer schools.

To quote band of brothers: "The only hope you have is to accept the fact that you're already dead. The sooner you accept that, the sooner you'll be able to function as a soldier is supposed to function: without mercy, without compassion, without remorse. All war depends upon it.” Not really relavent to Air Force medicine, but just something to think about

I want to be a physician to help sick people - if those sick people are in the military/military families for part of my career, what difference does it make? Please educate me.

Again, wanting to take care of sick people is great for any physician. The military population is younger and healthier. So what patient population do you want to take care of? You should be able to list reasons why you want to take care of soldiers specifically instead of the general population. If you want a diverse clinic schedule with lots a variety and complexity of patients, then you won't see that in the military very frequently.

 

[Gastrapathy]

You don't want to deploy. You've answered your own question. If you join and then play games to avoid deployment, someone else gets to go twice.