anyone considering military medicine?

[barb]

I am applying to USUHS, the military's medical school and was wondering if any of you were doing the same and had any thoughts on the issue. What are your concerns about military medicine? Will owing the services time in exchange for a free medical education be worth the sacrifices we will have to make? Also, if you have any thoughts on the HPSP program, I would appreciate those too.

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[edmadison]

The number of posts on this topic is huge. Just do a search on HPSP and USUHS. If you have any further questions, post them here. We will be happy to answer

Ed

 

[johnM]

when is the deadline for HPSP? Do you have to be accepted before applying? I've already been accepted to USUHS, but I'll probably get in to a few more schools (i've had several interviews) and I'm considering HPSP, just don't really know what I want to do yet.

 

[mpp]

Is there a reason you would choose HPSP over USUHS?

I sort of thought of the answer. You may want to go to some other school. But do you have other reasons of choosing HPSP over USUHS?

 

[mpp]

By the way, have you seen this guy's <a href="http://lukeballard.tripod.com/HPSP.html" target="_blank">site</a> regarding HPSP?

 

[PainMan]

If you feel you can live on 12k a year take the HPSP over the school. Sure, you are paid more at the school, but you owe 7 years instead of 4.....

 

[johnM]

I'm not sure that I would take HPSP over USUHS, I guess that I just want to keep my options open. I actually really liked USUHS, and I think that it would be a great school for me. The only thing is that it seems to cater more towards people who want to be in the military for life. I doubt this is actually what I want to do, and like 3mc1dj says, the shorter commitment might be better for me if I can live without the fat paycheck from USUHS.

 

[T.A.M]

I thought I'd contribute a few thoughts about military medicine. I'm going to med school next year, but right now I'm a medical service officer in the army, and I've worked extensively with army physicians. I don't know how much this will correspond with the navy and air force, but I'm sure its somewhat similar. When considering if HPSP or USHUS is right for you, there's one point that the military literature doesn't really mention. Even in peacetime, you will probably get deployed several times throughout your career, especially if you are a primary care physician. These deployments can last anywhere from a few weeks on training missions to over 6 months on peacekeeping rotations. The facilities you'll work in vary from little more than tents for training exercises to solid, fully equiped clinics and hospitals for peacekeeping missions (well, at least in Bosnia and Kosovo). As someone who has been deployed several times, I think its actually a very rewarding experience. You get a great chance to see the world in a very unique manner. I couldn't speak more highly of my experiences working on Medical Civil Assistance Programs in Kosovo. Plus, here's a little secret about deployments to Bosnia and Kosovo- physicians get tasked to provide "medical support" for what's called the "Fighter Management Pass Program" (FMPP). FMPP is like a short vacation for peacekeeping soldiers. From Bosnia, they go to Budapest, Hungary, and from Kosovo, they go to Sofia, Bulgaria. What does "medical support" imply? Basically, you work for one hour each morning pulling sick call. After that, you're free for the rest of they day to do as you please. You also get free lodging in the hotels (which are pretty nice) and an extra $60 a day in salary. Essentially, its a month-long paid vacation from your normal duties. Having been to Sofia, I can tell you that its probably the best kept secret in European travel. It has all the cultural advantages of its more well known counterparts (London, Paris, Rome, etc.) but it is dirt cheap. Of course, I realize that this sort of thing is not for everyone. If you're married, 6 months is a long time to be away from your family. Just consider how much tolerance you might have for the occassional deployment, and realize that not every deployment is as rosy as Bosnia or Kosovo. Also, keep in mind that these things might not apply to the air force and navy. Feel free to ask if you have anymore questions about a physician's role on a deployment.

 

[locitamd]

Sorry for reviving this thread, but I just got word today of my acceptance and my head is reeling, as I'm not certain I'm military material (so leftwing that, well I can't think of a that, but I'm v. v. left). So my question is this, what if you WANT to spend your career overseas and in the field and not on a stateside base? How likely is it that this can be arranged? Is there a way to guarantee that you won't spend 7 years in Georgia or @ Tripler?

Anybody w/inside knowledge about how it all works? It's much appreciated.

P.S. I haven't gone for my physical yet, can anyone share what's involved?

 

[UCMonkey]

locita - have fun at the physical.

If yours is anything like mine, they'll send you to MEPS for the physical. You'll have to get there at like 5:00am. Once there, you're supposed to get special treatment by virtue of the fact that you're gonna be a doc. Don't expect anything though. You will be processed just like all of the other enistees there. Basically, you'll be bossed around by a bunch of NCOs who think they have power. Just remember - in 4 years you'll vastly outrank them.

Among the things you can expect are:
-Vision test (both acuity and color blindness)
-Hearing test
-Drug test (pee in a cup)
-HIV test
-Breath alcohol test (blow into the tube)
-Discussion w/MD about your medical history, and a short exam (including hernia if male, pelvic if female). The MD will probably be older than dirt, and will treat you like you know nothing.

My advice: basically just do what they tell you and everything will go smooth. You'll probably be out of there by noon.

Overall, it was quite a pleasant experience (SARCASM).

 

[locitamd]

Wow, thanks Monkeyrunner. But really, that's it? No weigh in, no physical endurance/lung capacity tests?

 

[Aeromonas]

locitamd

I would hurry up and get your physical out of the way b/c i think you have until April 15 to get it completed. Plus you might have to have additional testing. As far as what they test you for it's everything monkeyrunner mentioned minus the HIV and drug test if it's done at a civilian practive. At least that was the case with me.

 

[UCMonkey]

•••quote:•••Originally posted by locitamd:
•Wow, thanks Monkeyrunner. But really, that's it? No weigh in, no physical endurance/lung capacity tests?•••••Oh, yeah - you're weighed and measured. I guess I just thought that was kind of a given.

I didn't have to do a lung capacity test or a physical endurance test.

They do run you through a bunch of range of motion / balance / neuro exercises though. They do stuff like make you do large arm circles, stand on one foot, duck walk, etc.

 

[locitamd]

Thanks tk421 - I know I've been dragging my feet about it since I interviewed on the last day (2/14) and thought there was no chance in hell. But low and behold, I got a phone call from USUSH today asking me to expedite my physical so I can get to Texas by June 17th. I'll have to go to a civilian testing site, since there aren't any military ones nearby - but I also need to have a crown fixed and I know I can't pass w/o having done that first.

But do you guys have any knowledge about my other questions? Or perhaps, know how I can find them out?

Thanks again.

 

[tec]

I spoke with the Army's GME director, while not directly involved in post-GME placement, has spent over 20 years in the "system," so I gave merit to what she told me. She said there are enough people who want to go to various assigments- some who want to go operational (to a division) versus those who want to go overseas and those to stay stateside. A lot of the natural differences in the preferences of the individuals help the Army sort people where they want to go. Hope this helps.

 

[locitamd]

very much so. thank you. Ok, now to schedule that physical (oh joy)...

 

[Cdc28p]

I've done a bit of research on AFHPSP, both on this forum and on the net, but have found conflicting info, so I hope some of you might know better and help me out...

1. If I really want a civilian residency, will I be guaranteed to get it? Or do I have to include some military residencies on my match list and thus might get assigned to a military one?

2. Is it possible to to do a residency that must be done at a civilian hospital, i.e. neurosurgery? Or do I have to pick a specialty that has military residencies?

I am extremely interested in serving in the military as a physician for a period of time but concerned about the freedom of selecting my residency. Hence, this last question...

3. Is it possible for a post-residency physician who has never had any military experience to join the armed forces and serve as a physician? If so, how will such a physician be ranked compared to the military-trained ones?

Thanks in advance for your answers.

 

[algae]

I have also done alot of research into the AF and Army HPSP's. From what I've read in the HPSP handbook, you must pick 5 residency programs total among the military choices. If you don't get one of the 5 choices, then you may be able to defer to civilian programs. If you want to do neurosurgery and the military only has 2 programs, then you still have to pick 3 other programs in the military even if its outside your specialty interest. Where ever you match, you go, so it's possible you could end up outside of neurosurgery. From what I gather from talking to physicians currently in army residency programs, the army programs are top-notch training. I don't know much about the AF, but would like to since I may have to decide between the two. I know there is a military program where they will pay back your loans once you are a doctor, but I's suggest you talk to a HP recruiter on that.

 

[johnM]

•••quote:•••Originally posted by algae:
•I have also done alot of research into the AF and Army HPSP's. From what I've read in the HPSP handbook, you must pick 5 residency programs total among the military choices. If you don't get one of the 5 choices, then you may be able to defer to civilian programs. If you want to do neurosurgery and the military only has 2 programs, then you still have to pick 3 other programs in the military even if its outside your specialty interest. Where ever you match, you go, so it's possible you could end up outside of neurosurgery. From what I gather from talking to physicians currently in army residency programs, the army programs are top-notch training. I don't know much about the AF, but would like to since I may have to decide between the two. I know there is a military program where they will pay back your loans once you are a doctor, but I's suggest you talk to a HP recruiter on that.•••••This is what I though too, until I got this topic cleared up on a recent thread... <a href="http://www.studentdoctor.net/ubb/ultimatebb.php?ubb=get_topic;f=2;t=002183" target="_blank">here</a> there is an Army recruiter who goes by HPSP, very informative and helpful. It seems that if the field you want doesn't have residency programs in 5 places and you get stuck with a program that you don't want, then you CAN defer to a civilian one. The thing is, most people from USUHS don't want to, since you would be ranked lower upon re-entering the military, etc. But at USUHS this generally isn't a problem since ~95% get there top choice anyway.

 

[johnM]

•••quote:•••Originally posted by locitamd:
•Sorry for reviving this thread, but I just got word today of my acceptance and my head is reeling, as I'm not certain I'm military material (so leftwing that, well I can't think of a that, but I'm v. v. left). So my question is this, what if you WANT to spend your career overseas and in the field and not on a stateside base? How likely is it that this can be arranged? Is there a way to guarantee that you won't spend 7 years in Georgia or @ Tripler?

Anybody w/inside knowledge about how it all works? It's much appreciated.

P.S. I haven't gone for my physical yet, can anyone share what's involved?•••••locitamd, congrats on your acceptance!
I'm also accepted (for the army) and almost certainly going to USUHS next year. From everything that I understand, you will not have a problem going overseas if you want to. This is actually one of the main things that attracts me to the military too, as it is very hard to live (and practice) anywhere besides in the states if you are not in the military, simply because of financial reasons. I'm not exactly sure how it works, but you do have the opportunity to request to be stationed at certain places, and are likely to get one of them. Of the two military docs I know, one is a pathologist who works in my lab here at the NIH and one is getting ready to move mis family to Japan for a few years. Both requested these sites and they didn't seem to have any trouble. Personally, I am willing to go anywhere, and I'd kinda be excited to do so.

Monkeyrunner, where did you get your physical done? Mine seems a lot differnt. I went to Walter Reed in DC, they didn't do the breathalyzer test thing, but I did get all the other stuff you listed plus an EKG and dental exam (w/ x-rays and everything). It took a really long time (about 5 hours all total) and started at 7AM, but they treated me really well. Seriously, everybody was totally cool with me, and the doctor I saw who went over my medical history was great. She was really cool, actually worked at USUHS for a while, and was really encouraging and talked to me a bit about doctoring in the military.

 

[UCMonkey]

johnM,

Man, I wish I'd had your physical exam experience. I had mine done at teh MEPS (Military Entry Processing Station for the benefit of those who don't know what that is) in Sacramento, CA. Unlike you, I didn't have the EKG or dental exam w/ x-rays. I'm wondering if that could have been an age thing - you're not an older applicant are you?

Oh, and aren't we going to meet in person at Finch on Tuesday?

 

[johnM]

I don't it's an age thing, I'm just 23. but as well as my physical went, i just called dodmerb and they told me that WR hasn't sent my file to them yet! god, it's been a month, i figured it would be finishing up by now!

btw, monkeyrunner, when did you interview at USUHS? I was on 11/1 and I remember a guy from Davis, wondering if that's you?

 

[UCMonkey]

OK, its definitely not an age thing. The person you met at USUHS wasn't me; I haven't interviewed at USUHS. I'm doing HPSP. Maybe that explains the difference in our physicals?

 

[tec]

The physicals for HPSP are done at a MEPS station. The physicals for USUHS are done at an actual military medical facility, unless you live far away from one (then you will go to a civilian facility). The DODMERB physical for USUHS is much more stringent. But HPSP students will be required to take another physical during their fourth year, prior to going on active duty.

 

[tec]

Even though both the Army and Air Force HPSP operate through the Joint Service Graduate Medical Education Board, the method by which their respective HPSP students are selected for residency differs.

The previous posts for the Army were primarily correct. However, you are required to state what your career goal is. For example, if you wish to be a pediatric neurosureon, then you are encouraged to list both a mix of peds and neuro programs because either residency will help you towards your career goal. (This was the example the Army's head of GME used with me, not that I have any desire for that career goal) However, if your only desire is to do emergency medicine, then you would list the three locations with EM residencies and then list a second coice of specialty, with the understanding that if you match to it you must go, or put transition internships for your first year and to re-apply for a categorical EM residency the next year, which you will more than likely get. This transitional internship counts as your internship year and does not change/add to/delay your payback. Your list is a combined specialty and location list.

The AF does their match slightly different. Each spring the heads of the specialties meet and determine the number of physicians in each specialty that will be needed when that year-group completes its residency training. That determines how many slots are available in each specialty. However, if they need more physicians than they have AF residency slots, they will farm-out the remainder to civilian residencies. For example, if they determine that they will need 30 anesthesiologists, but that there are only 20 AF slots (completely hypothetical numbers here), then the remaining ten will be as civilian deferments. The board will "rack and stack" (their term) their applicants. Each applicant must list two specialties or a specialty and transitional year (if the applicant only wants that one specialty). Within each specialty the applicant then ranks the locations at which they would like to do their residency. The highest rated applicant will get his/her top choice of residency. Once the board selects the specialty that the applicant will receive, itthen goes to the location list. This location list can include a civilian deferment. Thus, they choose specialty first, then location. This is my understanding of the info I received from one of the majors at AFIT.

I know this got long but I hope it helps.

 

[Cdc28p]

Thanks, tec. Your post is very helpful...

Just another, perhaps silly, question that might be hard to answer: are military physicians generally less politically conservative than the rest of the military?

 

[tec]

I spent five years as an active duty Army officer, so think I can help a little in this area. The running joke always was that the Medical Corps wasn't part of the "real" Army. They were definitely focused on their medical arena. But even so, the senior military officers that are always seen on TV (i.e. generals and admirals) who have been in 30+ years, do tend to be politically conservative. I think this is more a part of their generation than the military "brainwash" so many people believe happens. Remember, they came up in a time when society was very polarized and the public hated them for their role in Vietnam. However, the junior officers I served with (i.e. lieutenants and captains) and were very much moderate. I hesitate from saying liberal only because different people have different meanings in what liberal means.

 

[praying mantis]

Do you have to go through basic training to be an MD in the military?

 

[PACmatthew]

As an Army PA (1LT) officer, I can shed some light on this. You do not have to go through basic training like the enlisted go through, but you go through officer basic which is specifically designed for medical personnel. There are no "real Army" officers in this program, and it is actually a lot of fun. The OBC course is just an orientation into the Army where you spend time learning history, doctrine, and basic things like uniform wear, cutoms, and courtesies. You do get to spend a week out in the "modified bush" which is actually an old converted field hospital (MASH-like) with AC and heat. There are no showers for this week, but that is no big deal. We even had a coed platoon tent, which was a blast. The Army knows that you cannot push the docs too hard or they will simply get pissed off and leave. They treat the docs with 100% respect and make the experience very tolerable. You can go out at night when you are not in the field that week, and San Antonio is a fun town to do it in. Anyone wanting to go this route needs to realize that high school PE had some tougher aspects...but wasn't near as fun. If you want to laugh your butt off, watch 50 docs learning to rappel down a 5 story wall!!!

 

[Cdc28p]

Is it possible to join the military and practice medicine only AFTER my civilian residency? I want to have as much freedom as possible to pick my residency (because it's crucial for my medical training), but I really want to serve in the military for at least 4-5 years. Will I only be considered for the Reserve then or will I be allowed to go through the normal OTS thing?

 

[Cdc28p]

Any answer?

 

[scooter31]

cdc-
to answer your question, yes you can join the ranks after completing your residency. I'm looking into the AF HPSP program, and the recruiter I spoke with did mention recruiting civilian docs. The nuts and bolts of it, I'm not too sure about. But it's an option for sure... hope this helps

 

[edmadison]

You can certainly join as a practicing physician. There is one other option too. It's called the Financial Assistance Program. This program is for residents. You get money each year to pay back your loans and then pay back a year for each year you got the dough. The one draw back to this program, the payment is definately taxable.

One other thing you might want to look into is the Guard/Reserves. They will pay a big chunk of change (50K I think), if you sign up.

Ed

 

[Herr Doktor]

For what it's worth, I have a very close friend who went to USUHS, participating in the NAVY program. She absolutely loved it, especially since she is a single mother. She was able to easily have her requests to serve abroad in Spain and various other European locations fulfilled. Also, throughout her "payback time", she spent outside time working in local civilian hospitals. She has left the services upon compl,eting her settled time to practice dermatology in San Diego, just the way she has always wanted to. According to her, the training she received is incomparable to that any other physician could imagine. She was deployed to the Persian Gulf, became trained as a flight surgeon etc.

Hope this might help.

 

[johnM]

•••quote:•••Originally posted by Herr Doktor:
•For what it's worth, I have a very close friend who went to USUHS, participating in the NAVY program. She absolutely loved it, especially since she is a single mother. She was able to easily have her requests to serve abroad in Spain and various other European locations fulfilled. Also, throughout her "payback time", she spent outside time working in local civilian hospitals. She has left the services upon compl,eting her settled time to practice dermatology in San Diego, just the way she has always wanted to. According to her, the training she received is incomparable to that any other physician could imagine. She was deployed to the Persian Gulf, became trained as a flight surgeon etc.

Hope this might help.•••••I didn't realize that you were even allowed to work in the civilian world during your military time. Has anybody else heard anything about this? I know that at USUHS we were told that students are not allowed to hold outside jobs, I'm not sure if this is just during the four years of school, or a general military rule. In any case, your friend sounds very ambitious!

 

[avhart]

I was wondering if someone could give an overview of the timetable involved and what they are looking for...I have tried meeting recruiters and looking at guides on-line, but I haven't been able to get a straight answer for when you apply, what they judge you on, and so forth. If you don't want to clog up the thread, just send it to me. Thanks!