Air Force scholarships

Discussion in 'Medical Students - DO' started by andrea, Oct 11, 2001.

  1. andrea

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    Hi everyone! I was wondering if any of you have feedback regarding your Air Force scholarships - i.e., if you are happy being part of the Air Force, what OTS is like, how you balance school and military obligations. Thanks!
     
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  3. Talus

    Talus Junior Member

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    There is a threaded discussion the HPSP over at Physicians OnLine. If you're not a member, I will be happy to cut and paste the posts; then email them to you. Some of the responses go into details about the obligations; mostly negative stuff!
     
  4. I've been considering the military scholarship, so I'd love to have the post pasted on here so I could read the pros and cons. I don't have a password for the Physician online website. Thanks.
     
  5. maddogdo

    maddogdo Junior Member

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    I am stongly considering this as well. I would greatly appreciate those articles and any insight you can give me. Thanks
     
  6. andrea

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    Here's the posts - beware as it is overall very negative (and long)!

    from usmedicine.com
    February 2001
    Letters To The Editor -

    Military Physicians Leave For A Plethora Of Reasons I have been reading several of the articles in your publication concerning military physician retention. I have recent experience with military medicine and find
    much of what has been written very accurate.

    I do wish to add some things:
    During my four year stint in the military I did not witness one single physician with the rank of O-4 or below remain in the military beyond their initial obligation for HPSP or USUHS. Thus, from what I have
    seen, military physician retention at the rank of O-4 and below is zero. This goes for all specialties across the board.

    The only physicians I have seen stay are those in ranks of O-5 and above who seem "stuck" in the system for whatever reason. But, they are certainly in the
    minority and are mostly in administrative non-clinical jobs.

    This all combines to produce a practicing military medical corps that is consistently youthful and relatively inexperienced.

    Why this severe military physician retention problem? Obviously, the military is not a good place to practice medicine. Here are some contributing factors:

    Low Pay and Difficult Working Conditions. Why continue to work for the federal government, [which] is consistently demanding more and more from physicians,
    when one can go to the private sector and still work as hard but be much better compensated for it? This is true for all specialties and is a "no-brainer."

    Inadequate Retirement Plan. The retirement plan is not a good deal for physicians. This is because it is based upon "base pay" only, and is not based upon the total income.

    Too much Managed Care. The military now seems to have a love affair with managed care, and has forced it upon its physicians. Unless one shares this passion for managed care, practicing medicine in the military,
    especially as a "PCM," is demanding, difficult and frustrating. This is mainly because one does not have the autonomy
    to limit the amount of HMO patients in his or her practice. Military medicine (in the MTF) is now 100 per cent HMO. One primary care physician who recently left the
    military described the experience as "hellish" because of this. This leads to the next reason.

    Lack of Autonomy. All physicians place a high degree of value upon this, whether they are willing to admit it or not. Most, if not all, physicians are strong-willed, independent people or they would not
    have the "right stuff" to get into and through the rigors of medical school and residency. (If the military allowed them a residency—which is a whole other problem.)
    Military physicians, simply because of the
    organization they are in, have less autonomy than any others. Granted, this is given up when one chooses to "sign on the dotted line" and accept money from the government for medical education. But as soon as
    freedom can be regained, most take advantage of the opportunity. However just because one "belongs" to the military does not mean that there needs to be as much micromanagement of military medical practice that there now seems to be. This micromanagement is a direct result of total "managed care."

    Loss of Traditional, "Old-Fashioned" Medical Values. Military medicine now seems to be concerned more with numbers such as "metrics" and "productivity." Whatever
    happened to the patient? The patient seems to have become lost in all this. In
    fact, the patient no longer exists at all; this is evidenced by the fact that the patient has become a "customer." Pardon me, but a "customer" is someone who buys a
    hamburger from McDonald's. A "patient" is someone who seeks the help of a physician. But wait, the physician has been lost also, the physician no longer exists either but is now a "provider." So, we have "customers" "accessing" "providers." This doesn't sound like medicine at all. Sounds more like business doesn't it?
    So, there we have it folks, military medicine is now all about business. What is business all about? MONEY. So, what is military medicine all about now? MONEY.
    Yes, private practice is about earning money also, but it is not the prime focus. Believe it or not, most physicians I know did go to medical school because they wanted to help people. People are what is most important in their lives, not making money. On the other hand, the prime focus of military healthcare as a whole now seems to be centered around money. What does this have to do with physician retention? Practicing medicine in such an overly cost-conscious environment is often very difficult and frustrating because of the limitations that are imposed in an
    effort to preserve that which is valued the most: money. What limitations? Limited pharmacy formularies, strict referral criteria, and the many other limitations
    imposed by managed care.

    Career Progression Leads Out of Clinical Medicine. In the military, achieving higher rank (and thus higher pay), almost certainly means leaving the practice of medicine for a "desk job." This is a good thing for
    physicians who don't want to practice medicine anymore, for whatever reason. But for most who want to continue the full time practice of medicine AND experience career progression, there is only one direction to go: out.

    Promotion Dependent upon Unnecessary Non-Applicable Professional Military Education. In the military, physicians cannot be promoted beyond the rank of O-4
    without "Professional Military Education." This "PME" is not geared toward medical officers in any way shape or form, but rather is totally oriented toward line
    officers. For a physician who wants to become a line officer, this is probably a necessary thing, but how many of those are there? Furthermore, I doubt we will ever see a medical officer in command of a line organization.

    Little or No Professional Development. The military continues to deny medical school graduates the opportunity to obtain a seamless medical education from medical school through residency before entering
    practice. The military has come under congressional heat for this and deserves every bit of it. Hopefully, Congress
    will keep the pressure on to put an end to this archaic practice. No need is so great as to justify this. All too often, these unfortunate physicians must serve out their entire time with incomplete medical
    training, because the military then refuses to provide them with the additional education they need and ask for, or they are so disillusioned and disappointed with their military medical experience (after what has
    happened to them) that they just want to get it behind them. This goes for GMOs and GMO-flight surgeons. Speaking of GMO-flight surgeons, isn't it baffling that its pilots—among the military's most valuable
    human assets—are being cared for by its least trained physicians? Go figure.

    This list is by no means exhaustive. I could go on and on, but I think most would agree that I have hit the big ones. Will anything be done to correct all this and thus the
    physician retention problems? It's anybody's guess. But, I wouldn't hold my breath.
    —NAME WITHELD

    I have a different attitude! I enjoyed my military time, had some great experiences and feel like I learned a great deal. I only left so I could complete my training. Yes it was a pain not being able to go straight through, but during the last 5 years there
    was huge cuts in GME. I don't blame anyone and would gladly return after my training is complete.

    regards

    In the early eighties I went through medical school on a U.S. Army HPSP scholarship. Upon graduation, I was informed that I could not perform my internship in a civilian program but was required to accept a military internship. I reluctantly applied and was accepted at the Army's supposedly "premier" program in my specialty only to find it was in disarray, lacking in quality instructors, and staffed by inadequate and poorly trained ancillary staff. Needless to say, I was very disappointed and discouraged. I elected not to enter military residency after internship and became a GMO (General Medical Officer) for several years to fulfill my obligation. In addition, we were required to put up with all the military bull**** while passing through one of the most stressful periods of our lives. Upon completing my military obligation, I entered a university residency to complete my training (I changed specialties and had to complete a second
    internship).

    I would not recommend anyone accept an Army HPSP scholarship unless they really and absolutely know what they were getting into. Do not believe for a minute that they will give you a deferment to train in a civilian program when you graduate from medical
    school. Look very closely at the quality of the residency program you might enter. Finally, make absolutely sure you are military material before signing up.

    I doubt that all military training programs are as poor as the one I was required to enter. Over the years (and while in the Army) I have worked with many military trained physicians and found most to be of
    high caliber and expertise. However, very few of them have much good to say about the military. I believe that most (though certainly not all) quality physicians leave the military after their obligation not only because of the relatively low pay but also
    because of the excessive bureaucratic intrusion and poor quality of care. Imagine the worst Kaiser system with a bad paint job.

    I would certainly not advise any indentured medical student to defy the military lest he or she find themselves in some deep ****. There is no such thing as military justice.

    I was naive enough to listen to the Army Medical Center's rhetoric about the quality of their program. I must add once again that not all Army GME programs were as disorganized and lacking in the qualities that make for good training.

    I also want to add that my years as a General Medical Officer (GMO) were not particularly challenging but neither was it stressful. It gave me four years to
    think aout what I wanted to do with the rest of my life.

    I spent the time being a Dad to my two kids and also going to graduate school. So I spent the time well. In retrospect I would never had taken an HPSP scholarship. Who knows...things could have turned out
    worse. I am not bitter about my military sevice but I would not do it again or nor recommend it to anyone.

    Response - Anon_bc471b on 05/30/01 02:02 PM
    Military medicine has changed dramatically in the 6 years I have been in it. I have 1 year left on my obligation, and will definitely separate when my time
    is up. I did a military residency and think I was very well trained, but it seems the military is putting less time, energy, and money into GME. I am very concerned about the direction I see residency training
    in the military going. The military seems to be more concerned about implementing the new PCO clinic concept and keeping track of all it's so called ways of tracking productivity, that it's lost sight of both
    good patient care and keeping it's own providers somewhat happy. I don't know of anyone I work with at my institution that will stay in beyond their committment. I also know of someone who is getting out
    as an 0-5 with 14 years in because he realized the extra $40K a year in retirement is not worth spending 6 more years on active duty making at least that much less than he will make in his civilian practice, as
    well as having to move his family every 3-4 years. Overall, things have worked out well for me and I am not bitter, but I wouldn't necessarily recommend HPSP to incoming medical students anymore either.

    Response - Anon_9bf7a3 on 05/30/01 04:31 PM
    I have been in for 15 years and am thinking of leaving because assignments are not binding, there is insufficient professional development funding, and the emphasis is on supporting a military lifestyle of
    comfort rather than on medicine. The doctors are an appendage. Our clinics are understaffed with nurses, or nurses masquerade as doctors (Fort Jackson, S.C.). The records are often missing. The best way to describe the place is this:They pay the administrative types first--the Rear-Echelon MF's--then they appoint a non-clinical
    person to command doctors, then they abuse doctors. It's a Hollywood Drop. There isn't much behind the front. Doctors are leaving. Over in the Navy, the band is still playing, but the stern is in the air, because
    the anesthesiologists are leaving (while nurse anesthetists are running higer liability rates in civilian life). See www.uscova.org for the article by Colonel Hackworth (Dec, 1999, Archives, www.Hackworth.com).

    Response - Anon_bc471b on 05/30/01 05:44 PM
    I have watched morale at my current hospital plummet over the past 2 years. Every department is way understaffed with providers, nurses and technicians.
    We are losing 4 providers to PCS or separation this summer and getting 2 in return. The command comes to us every day asking us what we plan to do about the
    number of available appointments this summer. The solution is simple - get more bodies, even if that means civilian contractors. However, their answer was
    to tell us that no one can take leave or TDY until further notice. Good thinking.

    Response - Anon_bc471b on 07/18/01 05:30 PM
    I posted that response, and no, this is not a mecca. Idid train at one of the military " Meccas" for residency, and feel that I saw a lot during my residency, and worked with some great teachers/attendings. I feel that I am very well trained and well equipped to handle most situations I have encountered here. However, I have kept in touch
    with people who are still at my former training program and hear that things are changing there as well. The ward and ICU have half the bed capacity that they had when I started my training there due to
    nursing/tech shortages - this is not ideal for learning opportunities for residents to say the least. Everyone I've talked to says PCO is a disaster so far. They all agree that the bottom line is numbers only,
    not quality of care, and certainly not residency training anymore. I can also tell you that morale here sucks worse than
    it did 2 months ago. Almost everyone I know here is tired and pissed off. Our commander, who is not a provider, or even a nurse (Military Career Admin type) will go in and create additional appointments during lunch and after regular clinic hours because we don't have enough appointments to meet their access criteria. Well, part of the reason for this is because we lost several providers to PCS, pregnancy, and separation, and the command denied our requests for manning assist twice. Despite the new PCO system which was designed to improve access to care, we now have about 800 fewer appointments per month because the command reduced our staffing by 50% over the past year because they said we only needed X number of PCM's based on the number of patients in our local area. We are now getting record numbers of patient complaints
    regarding lack of available appointments. The hospital patient rep is down here every week with complaint letters that we then have to respond to with a formal letter to our SGH. They will cancel an entire morning
    of clinic for all providers for commanders calls, changes of command, "mandatory briefings," etc., and then bitch at the end of each month about our access. We spend so much time chasing our tails here it's not
    funny. Luckily, I can see the light at the end of the tunnel and will be separating in 1 year. Despite my above complaining, I have been lucky - I received good residency training, received a great assignment as far
    as location goes, have met some wonderful people, and have zero debt from my education. But, would I recommend to someone starting medical school that they should take an HPSP scholarship now?? I seriously
    doubt it, although each individual may have different needs, tolerances for military life, etc.

    Response - Anon_7a6a34 on 07/21/01 09:12 AM
    bc471b - Your experience is typical. Isn't it
    interesting that the air farce doesn't tell potential physician recruits about these things? Highly unethical, in my opinion. All we can do is tell potential recruits ourselves - I wish someone had taken the time to tell me. Several of the physicians
    at my hospital (I use that term loosely) have already contacted the premedical advisors of their undergraduate schools. They have told them to tell these kids the truth.


    There's more, but you get the idea. Opinions??
     
  7. johndean11229

    johndean11229 Member

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    this makes me really sad, the article i just read..i really want to do the army, but i now i m hesitated....can more people please write in about their experiences and why they did or did not do it??? we need more info guys before we sign that form!!!
     
  8. asilvey

    asilvey Member

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    There were many complaints from Army and Air Force physicians. This backs up my desire to go NAVY-MED! Also, tuition-free med-school, no malpractice, and an opportunity to see the world for four years? Sounds good to me! Finally, after serving for four years in command of a clincal staff, shouldn't you be able to get a damn good residency?????
     
  9. mikeaparker

    mikeaparker Senior Member

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    I believe that you do your residency before you give your 4 years to the Navy...

    Could anyone in the Navy Program please elaborate... thanks..


    Mike
     
  10. Drake BA '02

    Drake BA '02 New Member

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    Hello everyone. This is my first post, but I have gained alot of good information from this forum over the past couple of months. From what recruiters have told me you can choose to do only an interniship after graduation from medical school, serve your three or four year commitment as a gneral medical officer, and then apply strictly to civilian residencies, with your commitment behind you. Definitely a good way to go if you believe you may be forced into a military residency that you see as being less appealing that a civilian residency.

    Brendan
     
  11. FutrDr. Watson

    FutrDr. Watson Junior Member

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    Wow, it's great to hear the other side of the HPSP scholarship. I have been offered a 3 year Army scholarship and have been buying as much time as possible to make my decision. I think I will just go in debt. At least that way I can do what I WANT TO DO, and in turn be happy.

    Good luck you all
     
  12. YODA

    YODA Junior Member

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    Hey everyone,

    I am going to write in defense of the HPSP scholarship. I am a 2LT in the USAF and am doing the four year HPSP scholarship. I have heard nothing but positive things from doctors both friends and strangers. I have no idea where some people are coming up withe spare time to write three pages of bashing the HPSP and military programs, but I do believe they are either misinformed or something.
    Sure giving your life to the military is an unattractive thing to some but the positives really outweight the negatives. You get great healthcare and benefits, non taxable living expenses, great residency experiences with tons of hands on experience that is not given to students as readily in civilian programs. WIth the military you are exposed to up and coming technologies that civilian programs may not be finnancially ready to institute. The list goes on... sure its hard work... what part of medical school isn't. But I sure tell you I would much rather be worked pretty hard for three years of residency than not much at all. I feel that the military's program is aggressive and demanding, but you learn more about medicine and I feel that you also learn more about how to be a leader as a doctor... that is one of the most important aspects of medicine that is not taught openly to my knowledge.
    As far as pay goes... I have been to three bases and I would have to say that I have never seen a more convenient, safe, and great place to work and or live. Every convenience is at your fingertips from discounted grocery stores to golf courses. The pay is much better as well... the average resident in the civilian sector probably makes 20-30 thousand a year, where military residencts make 40-50 thousand a year. Sure when you finish residency you will only make about 60-70 thousand for the first couple of years but look at it this way.. you don't owe any money to anyone... and all of the money you take home is spending power and a good portion of it is non taxable. I calculated out the savings.... THE USAF Hpsp scholarship is saving me about 150-200 thousand dollars as of 10 year past graduation.
    Well I have more gross to review.. if you have any questions my email should be available. Take Care.... My advice is if you get the scholarship... take it.. its a once in a lifetime oportunity and its not a very easy offer to come by (quite comptetative to get)

    Peace

    YODA
     
  13. johndean11229

    johndean11229 Member

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    thanks so much yoda for finally saying something good!! i was all about to quit trying to get the scholarship, but now i think i m back in the hunt. it seems everyone is worried about the residency programs, i m taking it that you are gonna infact do military residency...you dont worry about if you ll get your choice? can you explain more about that? and also someone told me the base bay is 100,000 now for the 4 years, do you know for sure what it is?? thanks man
     
  14. jephyboy

    jephyboy Senior Member

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    not meaning to completely digress from the topic at hand: for those that went into GMO right after the intership year and not residency (to payback obligations faster), did you find it hard to obtain a civilian residency? Were you well prepared? Any other comments on this topic is welcomed.
     
  15. pyoj

    pyoj Senior Member

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    I go to school with YODA and i have to agree with what he say. however, i also feel that you should look into every scenario and both sides of the story before you make a decision. i'm sure your healthcare recruiters have contact information for active military docs and HPSP students. i'm sure they'll be more than willing to speak to you. these people are the best way you can get first hand info. take what recruiters say with a grain of salt, but everything they say is true. just make sure you do the research. and when you finaly do sign that sheet, realize that you WANT to be a military doc and NOT only doing it for financial reasons. otherwise you will end up like the guy who wrote the above article.

    there were several reasons why i chose army (in no particular order).
    1) my aunt is chief of child psych. at walter reed army medical center in DC.
    2)army has the most teaching hospitals compared to the other branches.
    3)the quality of students and doctors in the program are among the best in the country.
    4)DO's have a strong presance and a strong voice in the military.
    5)the former army surgeon general was a DO.
    6)military life would put an exciting twist to medicine (of course i'm only 23 and single...might be different if you're married, etc.)
    7)i'm interested in traveling to Korea as part of my active duty pay back.
    8)networking with docs from all over the military is easy.
    9)i have interests in sports medicine in general so what better place to explore this interest than in the military?
    10)in my mind the difference between a salary of 90G as a captain vs. 140G as a private sector physician has no great bearing on the way we live our lives.
    11)like YODA mentioned above, our residency programs are at the forefront of emerging medical technologies and techniques.
    12)the military doesn't have to worry about overhead costs of running an efficient hospital system. since everyone is commissioned a pay grade ("rank") everyone gets paid and i have to imagine that staffing a hospital is a bit less stressful, making your job as a doc easier.

    i can go on and on.
    ~pyoj, 2LT, MC, USAR
    COMP '05
     
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  17. mikeaparker

    mikeaparker Senior Member

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    I heard that being a military doc is just like being a doc in an HMO... they have a very, very strict formulary etc...

    They are also very very concerned with cost...

    Any comments on that????


    Mike

    p.s. this would not be a problem for me, because I have been working for an HMO for over 6 years and know what it's all about..
    You have to employ risk/benefit and cost/benefit analyses at the same time...
     
  18. YODA

    YODA Junior Member

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    I didn't mean to seem overzealous about going right for the military blindly. Definitely research all of your options. I spent two years contemplating the HPSP thing. Its a great thing in my opinion... but that is all it is "my opinon." Research your buns off and then make a decision based on what you want to get out of it...

    In response to the question about military residencies and practice being like and HMO. I really have no experience with those but I have heard from several doctors that the military has no malpractice, that their resources are much higher than civilian institutions, and that when it comes to military personell pretty much everything was covered. When I was COT (USAF Commissioned Officer Training) I needed a Tetnas booster and a Varicella (Chickenpox) Titer for medical school admitance. I did not have them and my private insurace had run out. I went to the on base hospital and in 1/2 hour I had the blood draw and shot free of charge. You tell me where you can wait only 1/2 hour, including paperwork etc, and get your stuff without any personal cost to you. I think the medical system in the military is fairly impressive (given my limited personal experience).
     
  19. dctrben

    dctrben Member

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    I just wanted to put my two cents in on the whole HPSP idea. I am currently active duty Army and from the patient side of things, the Army Healthcare system is sad. The doctors have little to no respect and the prevailing feeling is that most docs in the Army are there because they cannot cut it in the 'real world'. Unfortunately, as was mentioned earlier, the majority of practicing docs are relatively inexperienced and this just seems to fuel the lack of confidence the soldiers have in Army medicine.

    That being said, the problems do not at all lie solely in inexperienced docs. I think that the Army beaurocracy is into medicine up to its elbows and swiftly moving to the shoulders. An example is my wife trying to get a referral to an ENT specialist. They would not refer her there for chronicly inflamed tonsils unless she tested positive for strep. This despite the fact that her problems came on a regular basis and the fact that two of her sisters had similar problems that were treated with tonsilectomy and had no further recurrance. Oh, and she had documentation from a civilian doc that recommended they be removed. Anyways, the limitations put on what the doctors can do to treat the patient are debilitating.

    Another issue is the malingerer. Soldiers will fake symptoms just to get out of some sort of work, but they need to be treated as though they are sick. If these soldiers would remember that they knew the Army would be hard and wouldn't try to sham out, it would take a lot of strain off of the medical system, opening it up for better all around care.

    In conclusion, these are some outside observations made by someone that is hopeful to be able practice medicine. I have had some limited experience with Army medicine, mostly at the initial screening/treatment stage and have consistently been underwhelmed. Kudos to those of you that won the HPSP (I am applying for it as well), just remember that it is far from candy and roses. The Army is seriously in the stoneages when it comes to physical training and medical care.
     

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