Armed Service HPSP/other loan repayment options?

[Shellio]

Hi all - I am an MS1 that is starting to be overwhelmed by debt i will incur. I have talked to a recruiter and other students who are already part of the Air Force HPSP, and it sounds pretty good. However, I was hoping for some insight from anyone who is, or knows, a resident or beyond who is involved in this program. I am also curious about other options - i have heard there are a lot of programs out there that will help you repay your loan, but i guess I just don't know the right places to look. I have seen some, but i am looking for the ones that will make a big difference on a debt that will probably be 250K by the time i finish. Please help me and many others who probably have similar questions!
Thanks!

 

[edmadison]

You should be able to get the names of some residents to talk to from your recruiter. Mine was extremely helpful in this regard.

Regarding your second question, I will describe a few programs. Other people can fill in my gaps.

HPSP: Scholarship program. You sign your life away in medical school, most likely do a military residency and then do active duty payback as an attending. ADVANTAGE: You graduate from med school owing virtually nothing. DISADVANTAGE: Your choice of specialty may be limited by the programs available in your branch of service. Also, if doing Navy, GMO tours may increase your active duty comittment (in a very complicated way).

FAP: Join the military while in residency. They give you a monthly stipend (I think) and also a payment of about 30,000/year for loan repayment. ADVANTAGE: You join in residency so you specialty is already chosen. Disadvantage: You pay income tax on the loan repayment money.

Reserves/Guard. You can join the Reserves of Nation Guard and get a big fat check (~40 Grand). I don't know much about this one.

I thought FAP would have been a great idea, but being taxed on the loan repayment sucks, you'll loose 1/3 of that money. I would have still had a bunch of debt!

One last thing, the Air Force is stingy with its 3 year scholarships so get that paper work in and get a 4 year scholarship. Better yet, switch to the Army -- Hu-ah

Ed

 

[kaos]

Really? Could you explain more about the AF? I am seriously considering it, because the Air Force happens to be my favorite branch. R u saying that it's not the best way to go when it comes to the scholarship?

 

[Andrew_Doan]

HI,

I just joined the FAP (NAVY ophthalmology). It's an awesome program because you get to pick your civilian residency first (I'm doing mine at the University of Iowa). This is important.

As a GMO, you'll have one year experience as an intern and practicing general medicine during the payback. This is scary if you as me. Additionally, the military has a lot of say in which field you can go into. One of my colleagues wanted to be an ophthalmologist in the AF, and they said "No". She served as a GMO for 5 years, left the AF, and then applied for residency after that. Another friend was in the Army during medical school. He was allowed to match in orthopedics. Half way through his surgical internship, they said he was needed as a GMO and they cut his position. This is the nature of military residency programs. They have complete control over you.

With the FAP, you're in the inactive reserves status as a civilian with a future commitment to serve; which allows more freedom in regards to where you can train.

As for taxes, it's not a big deal. I get $39,000/year. You don't pay social security or FICA tax, so I pay about $9000 in taxes per year. You can then take your $30,000 to pay back loans.

Here's the BIG BONUS. If you decide to go into surgery, which can take 5-7 years of residency. You'll be earning $30,000 + your residency pay, which is about $37,000-$42,000 per year depending which stage of training you're in. If you have tons of loans, then you have about $30,000 X 5-7 years (~$150,000-$210,000) to pay back your debt or use it to supplement your lifestyle. You may even have more if you're frugal with your resident's salary.

With the FAP, my wife and I are able to have a family during residency and pay back my debt too.

Here's the SECOND BONUS. If you decide to do a fellowship that the military needs, then you can also collect the ~$40,000 per year under the FAP during fellowship training too. Therefore, you can potentially make over $80,000 per year during your residency and fellowship training at any major teaching hospital in the US.

In my opinion, the FAP gives you more flexibility in regards to career choices and how you decide to spend your money.

I hope this helps.

 

[agent]

where can i find out more info about this program?

i dont think there's any facilities in the chicago area so it probably wouldnt work out for me.

 

[Andrew_Doan]

Agent,

You don't need a local facility to be involved in the FAP. You join the FAP after you match for residency at a University/civilian hospital. Just go to your local military health care recuiter and ask them about the FAP (financial assistance program).

You can get some info from here too:

http://www.navy.com/traincareer/physician.jsp

Good luck!

 

[agent]

thanks.. i was reading about the army's one.. i believe they have a similar thing.

The main issue is at one point in time i was set to go into the marine core. I was disqualified last minute when they learned I had chron's disease.

I know they dont send you through basic in these military programs but I wonder if health would be an issue. I think im fairly fit, I play sports and all, but it just makes me worried.

 

[Andrew_Doan]

Agent,

All the branches have the FAP. It's the same benefits. You don't have to pass a rigorous physical, but I'm not sure if Crohn's will disqualify you. Best to check with your local military health care recruiter. If you need numbers or e-mails, then I'll send them to you.

Hope this helps.

 

[agent]

i actually got a local army reps email and asked for some info.

thanks again.

 

[mitchconnie]

To whom it may concern,

I am a surgeon in the military (AF) and went through the HPSP scholarship program. It was a GREAT deal while I was in school, but now that I'm out, I feel that I made a very poor decision. Practice in the military is currently miserable for many physicians. The recruiters will NEVER give you the downside, so do not listen to them. Here are the negatives.

1. Can't always pick your specialty-- no matter what the recruiter tells you, if they don't need people in your field you are STUCK. You'll have to do a one-year internship and do very basic primary care for four years. Half of the PGY1's in my residency were top-notch, top-of-their-class types who wanted to do something specialized (i.e. urology) that the AF didn't need at the moment.

2. Poor military practice conditions--The military is now enthralled with the HMO mentality--i.e. saving money is everything. HUGE cutbacks have taken place (my medical center went from 300 to 30 beds). As a general surgeon, I do not have enough work to maintain my skills. I will be unemployable when I finish my commitment. Equipment is 10-15 years behind. If you've ever been at a poorly run VA, you have some idea what its like.

3. Frequent deployments--with the number of overseas military commitments, some specialties (ER, Surgery, ortho, anesthisia) are deployed 3-6 out of every fifteen months. These are not fun-time, tour another country, trips. It's several months living in a tent in a barbed-wire compound in the desert. No family, no surgical practice, no entertainment. I'd be proud to serve in a war-time situation or even a humanitarian mission where I can use my skills, but treating colds and sprained ankles is not what a general surgeon is supposed to do.

4. Poor residencies--with the huge cutbacks, its difficult to maintain quality training programs. I believe that many military programs will soon be in trouble with the RRC. Although there are only 30 med-surg. beds at my hospital we still have internal medicine, surgery, and OB/GYN residencies. What kind of residency will you have in a thirty-bed hospital? Don't believe the recruiters--if there are open military slots, you will be forced to do a military residency. Many programs have partnered with civilian programs to improve training, but many have not.

I think some physicians have had a good experience--particularly in primary care areas, but most I know bitterly regret their decision. Talk to some active--duty physicians in your area of interest before you sign anything. Military medicine has been radically altered in the last 5-7 years and many recruiters and former military docs do not have a clue as to what is going on. I would never recommend signing up as a first-year medical student when you don't have a career path in mind. If you are in DESPERATE financial straights and there is no other way out, then sign up as a resident, when your training has been settled

 

[Pitt Panther]

I'm in a similar situation...I was/am planning on joining the military in order to help pay for medical school. I'm having trouble deciding how I want to go about doing this. My professional goal is to be a neurosurgeon however I do not want the military to tell me that I cannot go into neurosurgery because they do not have a need for it. Is this realistic? Do I have a shot at neurosurgery or is this something that the military will most likely keep me from going into? If that's the case then I'll suck it up and deal with the loans on my own.

 

[Andrew_Doan]

Originally posted by Pitt Panther
I'm in a similar situation...I was/am planning on joining the military in order to help pay for medical school. I'm having trouble deciding how I want to go about doing this. My professional goal is to be a neurosurgeon however I do not want the military to tell me that I cannot go into neurosurgery because they do not have a need for it. Is this realistic? Do I have a shot at neurosurgery or is this something that the military will most likely keep me from going into? If that's the case then I'll suck it up and deal with the loans on my own.

Hi,

In the Navy, there was a need for neurosurgeons this year through the FAP program. I'd recommend that you match first for Neurosurgery at a university program, and then apply for the FAP. You'll then get $40,000 extra per year for the next 7 years. I'm in the Navy, and this branch has bigger hospital facilities. As an ophthalmologist, however, I'm basically primary care for the eye, so I there aren't nearly as much deployment. In addition, the tour of duty for us is 3 years, but the eye docs I spoke with have been at their current locations for more than 6 years.

I think the experiences are very dependent on the speciality you go into. As a neurosurgeon, I'd imagine that you'd be based at a major facility, such as San Diego, Bethesda, or Portsmouth. These are the 3 major teaching hospitals for the Navy.

 

[Pitt Panther]

Would I be able to see if there was a need for neurosurgeons before entering through the FAP program? Or do I sign prior to finding this information out and take a chance that there will be a need.

 

[Andrew_Doan]

Originally posted by Pitt Panther
Would I be able to see if there was a need for neurosurgeons before entering through the FAP program? Or do I sign prior to finding this information out and take a chance that there will be a need.

If there wasn't a need for neurosurgeons, then you couldn't join the FAP as one. They look at the need for different specialities before the start of every fiscal year. This year, the Navy needed 8 surgeons and 4 could be ophthalmologist. Of the 8 surgeons, I think they needed a few neurosurgeons too.

The FAP is a program where the military can recruit specific specialities based on the current needs. I truly think the FAP is a sweet program and allows more flexibility.

 

[johnstoner]

ok so i'm going to ask everyone here that i asked andrew... is HPSP better than FAP or is FAP better than HPSP

HPSP positives... more money
negatives... not sure about residency...and questionable training

FAP positives... flexibility in terms of residency
negatives... less training....

if someone is not planning to make a career out of the military... what would be the best option...

I have my MEPS physical next week and I'm just thinking maybe i should just hold out on the military until after med school... what do yall think?

 

[johnstoner]

also... i'm probably planning to do general surgery or some sort of specialty.... most likely not primary care.

 

[perrum365]

i would just like to thank the posters to this thread. this is one of the most informative threads i've ever read on SDN. Thank you so much Ophtho_MudPhud and mitchconnie for your insight to military scholarships!

 

[ndn11]

The bottum line with the military is when you sign up you are theirs... You will do what they say regardless what you were told at sign up... Also as the motto goes the military will issue every thing you need - which does not include your opionion or a family.

You work so hard to become a doctor... It does not make since to lose the life that you dreamed of because of having some debt for a small time...

good luck.

 

[Andrew_Doan]

Originally posted by ndn11
The bottum line with the military is when you sign up you are theirs... You will do what they say regardless what you were told at sign up... Also as the motto goes the military will issue every thing you need - which does not include your opionion or a family.

You work so hard to become a doctor... It does not make since to lose the life that you dreamed of because of having some debt for a small time...

good luck.

I think this is rather an extreme opinion. Do you know any physicians in active duty? Have you actually spoken to several who are currently in active duty?

I know many Navy physicians who love their career; in fact, they love it so much that they lost 20 years of their life voluntarily and are now retiring soon. Your statements about losing your life is rather a myopic opinion.

 

[14931]

Originally posted by Ophtho_MudPhud
.....rather a myopic opinion.

me thinks someone is tooooo into optometry!



thanks optho for the comments.

 

[od2b]

How competitive are these scholarships and when is the best time to apply? Should you be accepted at your school of choice prior to applying?

Thanks.

 

[drtedjefferson]

jon, I'm sure you will do fine on your physical, but perhaps before you begin your military doctor career you should change your name from "JONSTONER" , just a thought.

 

[drtedjefferson]

or maybe I'm just giving a myobic opinion . Persons like you are in the sclera of your lives and without true refraction , you may find these plans too shortsighted. In my line of sight , you may see more than just iritic conjunctivae or risk presbyopia.

 

[wnkybach]

Allow me to share but a tidbit of what has been typical of my Active duty army doctor experience. Then you can guess how I feel about HPSP.

The Army is getting out of the business of training General Surgeons for many reasons, some of which have been elucidated in this thread. As a result, I am one of those whom they tried to force to go into primary care. In fact, the quote to me was... " You just need to suck it up and finish a family practice residency and work for the army as a family practitioner." I was not out of options at the time, however, it has required that I serve my sentence (yes, I did sign the contract but was lied to like everyone else I have talked to) treating sniffs and snuffles and twisted ankles, not to mention the perfectly healthy who have found a very convenient way to get out of work.

I didn't make a big deal out of being lied to at the onset because once obligated, I realized that it was a noble thing to be in the service of your country hence I just lowered my head, did my duty and "drove on".

I have a little over six months left and have anticipated greatly the day when I could kiss it all goodbye. I have not had any intentions of dealing with them ever again.

after interviewing, I have been offered 3 surgical positions outside of the match. Two of which want me to start "yesterday". I also have some very good match prospects. However, the one program I desire over all others, wants me right now. The position will not be available in 6 months.

Keep in mind that all of my complaints and disgust with the Army have been kept to myself (good advice for anyone who is "owned" by the govt.) In fact, I have had only stellar ratings (top 10%).

I approached them with a deal, such that if they allowed me to defer my remaining comitment, so that I could take that residency position now, I would sign on for an additional 2 years of comitment to serve them as a general surgeon. (keep in mind also, that just recently, they offered significant financial incentives to all general surgeons in the army in attempt to retain them. There is a significant shortage)

Can you believe that they have turned me down! Anyway, I guess I should be glad that they did. This has just reminded me of how horrible these past 3 years have been and I can't believe, I almost made the same mistake twice.

 

[drtedjefferson]

Wenkybch(now there's a name only a doc would recognize!) excellent advice. Much thanks for someone who's been throughit to share their experience. It does seem that way that primary care docs have a better experience in the military. I 've heard similiar stories from other surgeons , etc about the army forcing them into primary care.
But keep your head up. I just went through the match and was amazed at the open spots in surgery this year! Loyola University in Chicago ( a top notch surgery program ) had to scramble to 9 positions!!! This year was the year for people trying to get into General surgery and if you have to do another 6 months big deal. There were MANY scramble positions in general surgery this year and if you don't get in there is always prelim surgery. Here in the Chicago area where I am there were MANY surgical programs who did not fill in the match and had to take people in the scramble. I think exmilitary are also looked very favorably on by surgeon program directors (some of whom worked in vietnam and korea.) The program directors you interview with will also recognize that you have done primary care and have a more "well rounded" view of patients then their typical applicants who are fresh out of med school and don't know squat except that they want to be surgeons. If I were a program director adn I heard your story, and if you had decent test scores and a decent personality I would put you at the top of the list, and I'm sure they will too.
Everything is cyclical inthe match. a few years ago they were begging people to go into anesthesiology and radiology, now they are the most competitive in the match!! General surgery is down right now d/t the legal atmosphere, but I don't know anyone who doesn't say this is only temporary. So you have basically timed it perfect and if you really want to be a surgeon I'm sure you will . Best of luck (and check out chicago- many spots)
P.S. the next time you complain about your military experiences I will show you my 180,000 in student loans. LOL

 

[drtedjefferson]

one more thing, can you give me the straight answer, what are first year fap's making in the military in primary care??? Do they get the isp and asp and vsp, etc.??? Is it 70K or 100k or what? noone seems to answer this. Also , do you have to pay malpractice insurance??? assistance much appreciated.

 

[wnkybach]

Originally posted by drtedjefferson
one more thing, can you give me the straight answer, what are first year fap's making in the military in primary care??? Do they get the isp and asp and vsp, etc.??? Is it 70K or 100k or what? noone seems to answer this. Also , do you have to pay malpractice insurance??? assistance much appreciated.

Not sure I totally understand the question and I am not totally up-to-date on FAP's. However, my understanding is that when you sign up for the FAP, you agree to accept a given dollar amount (whatever that may be, and I suspect that the amount has nothing to do with what specialty you are in). That dollar amount is taxable and for every year that you accept it, you incure a certain amount of active duty payback time to be fulfilled upon completing residency. (Note: watch the fine print because even if it says "year for year" payback or something like that... you need to be aware that there is probably a reserve comitment attached as well, either IRR (individual ready reserve) or straight reserves) in addition to the active duty time --- that could affect your future practice plans depending on the type of reserve comitment.

Also, you may have been able to chose your specialty and get the training you desired etc.... but when it comes time to pay the piper, you will still have all the woes of active duty. You will be a Major and making major pay with all the special pay's, including a special pay that is different for every specialty. I don't have a list of all those pays right at the moment but could probably come up with one.

Another aspect that may be of more importance to some than others, yet not insignificant is.... The military has the attitude that you are a soldier who happens to be doing the job of medicine rather than a Physician who happens to be practicing in the military. I can tolerate their attempts to make me believe that I am a soldier first but, the way that they deal with and treat doctors is based on this flawed theory. Generally speaking, any respect that you get is only because of your rank and that is given spitefully because they don't feel that you have put in the military years and heartache it requires to reach such rank. I bring this up now because as an FAP participant, you will have no active military experience and all of the sudden be a Major. We understand the pain, blood, sweat and tears that it takes to become a doctor, most of them do not. I am not some power monger nor someone who whimsically demands respect, however, there is a minimum level of treatment that anyone who has sacrificed as much as we have should receive. It is often absent and especially during deployments. But I digress.

of note... I remember reading earlier in this thread, a question regarding HPSP vs FAP. Like I said, I don't know what the FAP yearly amount is but depending on what school you go to and how much tuition and books are, one program may be financially better than the other.. i.e.- if your tuition is 35 to 40 thousand a year like mine was, I did better (strictly financially speaking) by HPSP. They paid my total tuition and books/equipment as well as monthly stipend. Had I taken that all on myself through loans and then done FAP; say I got 40 thousand a year for FAP, minus taxes..... well, you can see where I'm going with this right?

However, if your tuition is only 6,000 a year, maybe FAP would financially be better.

sorry this got longer than I originally intended
out here.

 

[wnkybach]

also, malpractice is obviously handled during residency and when you are on active duty, there is no malpractice.

If I have mis-spoken at all regarding FAP's please let me know, thanks

 

[Blitzkrieg]

what is the FAP payback like? 1 year of mil service for every 1 year of residency payment? If so, that would suck for surgeons! Optho, please clarify

 

[Andrew_Doan]

Originally posted by Blitzkrieg
what is the FAP payback like? 1 year of mil service for every 1 year of residency payment? If so, that would suck for surgeons! Optho, please clarify

Hi,

FAP payback is 1 for 1, plus 1 year. So if your residency is 7 years, then payback is 8.

This doesn't really suck considering the nice life style and that you're receiving an extra 40,000 per year X 7 years.

Enough to clear any school debt or more.

 

[Blitzkrieg]

but Andrew..


neurosurgeons, for example, make $130,000 in the military. Yes, they will get an extra $40k during residency, but imagine the wages lost during that time in the military! When making $130k, they could be pulling down 500k, and by the 8 years is up, near $1million +.


FAP..not for me

 

[Former GMO MD]

First, to qualify myself:
I graduated from THE most expensive medical school in Chicago (it was when I graduated, don't know about now).
I was overwhelmed with those figures on the financial aid papers.
I accepted a 4 year HPSP scholarship
I completed a general surgery internship in the Army
I was forced to be a GMO, and did so for four years until paying back my commitment and getting out
I am now a PGY3 in General Surgery (civilian)
*********

Now, for any of you young souls who want to pursue a surgical career and are contemplating a military scholarship, let me make this very, very simple for you:

DO NOT DO IT!

That is NOT a typo- DO NOT DO IT!


Now, I know that might sound like a rather arrogant position, and maybe you are thinking it is to dogmatic to be good advice for everyone, but I hold firm that there is almost NO ONE interested in pursuing a surgical career that a military scholarship will benefit. Now, if you have some other reasons for wanting to be in the military, be it your family tradition or what, then fine, perhaps this is a valid option for you. But if you are just looking at the bottom line dollar amounts, DO NOT ACCEPT THIS SCHOLARSHIP!

When a friend enlightened me to the existance of this forum I felt it a worthwhile diversion from my residency duties to be sure I tried to keep as many people as I could from making the same mistakes I made.

And just to illustrate my point, one of my very good friends graduated from medical school at the same time I did, and from the same expensive school. She pursued a civilian residency in general surgery and I took the military path. In the time it took her to complete her entire residency, I was stuck rotting away in some troop medical clinic essentially babysitting and attending to runny noses and sore backs. This is of course when I wasn't deployed rotting in the desert on call 24/7. My friend has now completed 1 year of fellowship training and is working as a staff surgeon in the midwest. They live in a beautiful home and will have the loans paid off in a few years. Meanwhile, I am still looking at another 2 1/2 years of residency training. And, since the month stipend part of HPSP is the same for all residents regardless of the program you are in and where you live (this is the part that pays your room and board), being that I lived downtown Chicago I STILL ended up with medical school debt because the stipend wasn't nearly enought to even pay the rent let alone any other expenses like food. And let me tell you, the GMO tour I served was in an IDEAL location in a beautiful part of the country, so the experience that I had was in one of the best positions that the Army had to offer (the message between the lines, it could only get worse).

Now, I emphasize that this recommendation is if you want to pursue a surgical career. The reason for this qualifier is often the military DOES NOT make you do GMO time if you pursue a primary care field. So, that takes away one of the big deterents. However, you still end up a military physician, with all the rights and priviledges that WnkyBach elluded to above (ie the resentment towards the rank you are "given" and didn't "earn," FREQUENT deployments, which with the downsizing and the huge exodus of military physicians OUT of the military is only going to get worse for those IN). I have another very close friend, who also chose a military scholarship but took a primary care line and became a family practitioner. He did NOT have to do a GMO, but he is equally miserable currently serving his payback time and feels just as strongly as I do and would offer the same advice.

I could certainly get into more specifics to those of you out there who feel your circumstances are unique and maybe this advice wouldn't apply to you, and I would take the time trying to convince you just because I wouldn't want to wish that imprisonment on anybody. Take a hard look at the theme of the messages posted in this thread by those that have been through the system. I know those figures look inhibiting, but I'd rather owe the bank my money than the Army my life. And so should you.

 

[phil413ru]

I would have to somewhat agree with GMO MD. Whatever you do, DO NOT JOIN THE MILITARY JUST TO PAY THE BILLS-YOU WILL NOT LIKE IT! The military is a far cry from civilian medicine. This is not the job to take if you like complete control over you life, choosing where to live, and where to work.

HOWEVER. . .
I love the military. Join this if you love the military. Do it if military as physician, not physician in military. You need to really know what you are getting into. Military is a huge committment, and it is not a cheap way to get through med school--look at it like indentured servitude. I was in military first, and now going to Med school. I plan to spend career, but would have been in miliary anyway---even if not as doc. I want to travel, want to move around, want to work with troops. I like the structure and discipline. I like the leadership opportunity. I understand the dissentment over rank, because I have been at the bottom. My former Battalion Commander used to say, "Never forget the privates (bottom enlisted-Army).
Only do this is you want to be in the military. You are a soldier first, doctor second. Too many students pay for med school/ ROTC undergrad without realizing that it is the way it is.
The military is not for everyone. Talk to people--find out from both sides. Intricatly analyze WHY you would consider military. If it is for money, DO NOT DO IT. The military is not a place to make money. You will be able to repay. Try National Health Service Corps-year to year payback underserved area--not military. The military has a bad enough numbers problem now. The people we take in should WANT to be there. Otherwise, all stuff runs downhill, and your subordinates and patients will infer that you don't want to be there. Please, unless you desire to be military, do not do this. If you really love the military, then yes. Both NEVER for financial reasons.
Army life is not easy. There are many sacrifices. It will make for a miserable experience if you don't realize this. But, if you do, and still desire, and go in with eyes open and willing to put up with various obstacles, then go for it.
Best wishes.

 

[Andrew_Doan]

Originally posted by Blitzkrieg
but Andrew..


neurosurgeons, for example, make $130,000 in the military. Yes, they will get an extra $40k during residency, but imagine the wages lost during that time in the military! When making $130k, they could be pulling down 500k, and by the 8 years is up, near $1million +.


FAP..not for me

Clearly if you're in for total profit, then the military is not for you. If you want a rewarding career serving your country as a military officer and having your debt paid off, then the FAP is a wonderful option.

For those scared of a GMO, then pick the FAP.

 

[wnkybach]

Originally posted by phil413ru
I would have to somewhat agree with GMO MD. Whatever you do, DO NOT JOIN THE MILITARY JUST TO PAY THE BILLS-YOU WILL NOT LIKE IT!
HOWEVER. . .
I love the military. Join this if you love the military. Do it if military as physician, not physician in military. You need to really know what you are getting into. Military is a huge committment, and it is not a cheap way to get through med school--look at it like indentured servitude. I was in military first, and now going to Med school. I plan to spend career, but would have been in miliary anyway---even if not as doc.

Very sound advice that I would have to agree with. I only wish I had come across a thread like this during those days of decision. As a small gimmer of hope while facing those huge debts... Mind you, this is only one of a multitude of opportunities available that most MS-1's don't even think about.

I spent one year doing a transitional internship before becoming a GMO and have now been a GMO for almost 3 years. So, at the end of four years, I am now able to start my surgical internship with a modest debt load ( I refer you to GMO MD's comments on still having to take loans even while in HPSP).

I have friends who are in rural areas and after completing their internships, are now able to moonlight in the rural ER's (There are more opportunities than there are residents to fill them). They are making anywhere from $2000 to $4000 in a single weekend. Some of them were even allowed to do some moonlighting as interns. Anyway, long story made short.... I crunched all the numbers one day.... for the time that I have put in to get where I am now (still with some debt, mind you) I could have taken three years after internship and worked ONLY WEEKENDS and made as much to live on as the army is paying me, and... and... totally paid off ALL of my med school debt! All without the military elements elucidated previously.

Depending upon what type of residency programs you are trying to get into, in most cases, that time working as an ER physician would be seen as an asset to getting a residency rather than a liability.

Like I said, that is just one of a multitude of opportunities that are out there.

So, bottom line--- Don't do it for the money, Do it because you want to be a soldier and medicine is one job that soldiers can do.

 

[drtedjefferson]

Those of you that were GMO's , what was the total salary (with everything included??) Is it different now??? Anyone who was a FAP recipient inthe last year know the total salary? was it 70 , 80 or 90 $??

 

[Andrew_Doan]

Originally posted by drtedjefferson
Those of you that were GMO's , what was the total salary (with everything included??) Is it different now??? Anyone who was a FAP recipient inthe last year know the total salary? was it 70 , 80 or 90 $??

I'm in the FAP. I get $40 from the FAP and about $40 from my Residency. It's very nice.

When I finish, my pay will be around $110,000 and then hover around $150,000 after my 5 year payback is done.

 

[drtedjefferson]

I'm not too sure about that Ophtomudd, I was told a similiar story by the recruiter, but when I added the numbers, it comes to anywhere from 70-90 K, your first year and goes up to around 100K after completing 4 years. So look close at the contract(not just the pay chart.)
Anyone with experience know the answer????

 

[Andrew_Doan]

Originally posted by drtedjefferson
I'm not too sure about that Ophtomudd, I was told a similiar story by the recruiter, but when I added the numbers, it comes to anywhere from 70-90 K, your first year and goes up to around 100K after completing 4 years. So look close at the contract(not just the pay chart.)
Anyone with experience know the answer????

I'm also ophthalmology with higher incentive bonuses. If you're FP or IM you will make less. My ophthalmology bonus is almost $30K per year.

The incentive bonuses are based on your speciality. Here is a site to accurately calculate:

http://www.staynavy.navy.mil/

In addition, your pay is also based on a housing allowance which will be adjusted to where you're living.

 

[drtedjefferson]

Excellent site ophthomudd. I have been looking for a site like that for weeks, your assistance much appreciated. There are a few misleading things there though, and I think that the total is a good 30k less than they say, I'll tell you why.
1.)Government quarters value: =22k, this is basically the value of your quarters in the military that you would have to pay as a civilian. Problem is, in the real world you make house payments and at the end of your mortgage you OWN THE HOUSE. This is how people retire, they sell their 500,000 $ house and move to Florida and buy a 100,000 house. So subtract this, it's not real
2.)Retirement Compensation Value= 14k , this applies only if you spend all 20 years in the military and get this. so add it if you are absolutely positive you will spend 20 years in the navy and not one day less. Otherwise , subtract it.
3.)Commisary value=$1,200= the amount you save by buying all of your food on base (yeah right!!!)
The total real pay (for F.P.) I got is = $73,094, kind of depressing. but don't forget the 70k gross (40K net) you get in residency as part of the FAP. And As you get promoted your salary goes up another 10-20 grand the next ten years.
BOTTOM LINE: they give you 40k in residency then pay you 73K for a few years that then goes up to about 90K. Not great , not terrible.
Again thanks for your help, and good luck, I noticed you're posting today so you must have gotten stuck on call on t-giving like me too! There's nothing like old turkey in the hospital cafeteria to make your holidays.

 

[drtedjefferson]

I found this in another post:
"I will give you the most recent breakdown for a FP in the military (it ain't a secret, your recruiter can a should do the number crunching with you):

O-3 2,796.60/mo which comes to 33,559.20/yr
Total special pay 35,500(add another 10K for ophth.)
Basic Allowance for subsistence 1,996/yr (tax free)
Basic Allowance for Housing 15,564/yr (tax free)

total: 86,619 of which 17,560 is tax free. So, if you pay taxes at a rate of 21% on the taxable income, you are taking home about 72,117/yr in the military. No loans to repay if you went the HPSP route, but still repaying loans if you are a FAP recipient, so subtract your loan monthly payment from that amount.

Comparatively, as a civilian FP fresh out of residency and making lets say 125,000/yr and taxed at 30%, your take home will be about 87,500. Subtract 1,200/mo for student loan repayment if you attended a private school and your take home is about 73,100, which is comparable to what you would make in the military. However, keep in mind that many places will offer you some sort of loan forgiveness as part of your employment contract. So civilian and military salaries are basically comparable for a FP fresh out of residency, unless you go to a rural area, where you can expect,as a civilian, to exceed by a fair amount what you would be making in the military.

After 4 years in the military, you are eligible for a extra special pay of 14,000/yr (taxable). Which brings your total pay to 100,619.52. After your promotion rols in, you will be making about 107,000/yr.

OUUUGHHH TOOO MANY NUMBERS!!!!!!!!!!

 

[Andrew_Doan]

Now your numbers are closer. Just remember, as you pointed out, that the pay is based on your speciality and where you are based. When I interviewed at the Naval Hospital in Bethesda, the estimate was a starting salary of $105,000 for ophthalmology. However, I consider this good because of the tax savings as you pointed out, and this actually brings the total take home higher because you're in a lower tax bracket. In addition, many military personal pick states of residents where there's no state sales tax. We're planning to settle down in California, Texas, or Florida eventually and will be able to put one of these states down. In addition to the basic housing allowance and living allowance, your total salary may be STATE TAX EXEMPT. This is a huge perk of being in the military and will raise your take home salary almost $10,000-15,000/year based on a $100,000/year take home.

In addition, you pointed out that the housing allowance is useless for future investment. Remember that you can also use the housing allowance to purchase a home and pay a mortgage. Many of the ophthalmologist I spoke with are completeting 6-9 years at one location. This allows some time to build equity and for you to walk away with some investment in your home.

Finally, I agree that the retirement package that is reported on the website can be misleading. It's a sweet deal IF AND ONLY IF you stay for the full 20 years. If you don't, you will not see a penny. I plan on staying in for 20+ years and see the retirement pay as a big incentive to do so.

I like the military and the idea of working towards protecting our wonderful country and everything this nation stands for. I don't mind the pay cut because I never planned on being in private practice. I wanted an academic career and discovered that there are academic opportunities in the military at their teaching hospitals. Therefore, for me, whether I go into the military or academics, the pay is essentially the same. However, I feel that if I worked as a Naval Officer and Ophthalmologist, then I may make a bigger impact.

 

[drtedjefferson]

Interesting, I didn't know you could claim Florida as your state of residence and live on the military bases elsewhere. I grew up in Florida , my parents are there and I can use their address so I'm familiar with this trick people use to avoid state taxes. Interestingly , you will see alot of proffesional athletes do this. They all buy houses in Orlando, pay no state taxes and spend the year travelling. For instance, the next time you see a golf tournament on TV look where it says their from , they all list "Orlando Fl" as their home. Even though they are from all over the world (I read once Tiger woods avoided 50 million dollars intaxes doing this!!!) Ten percent added to your salary is a big deal, a very big deal.

Another point that I think people missed on this site when they quote "140,000 /yr to work as a civilian" is that that only works if everything (licensure,medicare , medicaid, publicaid licensure) goes off without a hitch- IT NEVER DOES!!!

Some of the doctors I know just out of residency have told me horror stories of how LITTLE they made their first year because of licensing hassles. Some stories:
1.)a good friend of mine saw medicare patients for 6MONTHS in his clinic for FREE, all because of the time it took to get licensed for medicare (they require their own licensure to get paid by them and they take FOREVER to get the paperwork done.) Then when he was licensed (finally) they refused to pay for the thousands of patients he saw under medicare until then!!! his total first year salary = 60K! and worked like a dog.
2.)But worse is if the damn bureaucrats cant get your State licensure done in time. Then you can't even SEE patients!!! can you imagine sitting around for 4 months waiting for some secretary in the state capital to file your paperwork as you are tweedling your thumbs with no income??? You try to call them to inquire and you get voicemails and dead ends- a common story.
3.)Opening your practice requires : Insurance (takes forever), a bank loan , setting up the office, reliable office staff (who aren't going to be rude to your pts while you don't know). Business licensure (local and state)
4.)"Privilages": people think that any doctor can go work in a hospital , just not true. You have to get "privelages" which means a board at the hospital of rich specialists (cardiologists, GI docs, Surgeons) has to review your credentials and will let you in only if they think you will SEND THEM BUSINESS. ie: if they want to do dangerous , invasive procedures to your personal patients you better not say no, or you will be working down the road! And again this takes time.
The moral is many first year docs who thought they would be millionaires fresh out of residency make only 60-80 grand because of these hassles.
There is a stability and a guarenteed good paycheck that appeals to me. When you hear these disgruntled army docs complain about the deployments, and being forced into primary care, etcetera etcetera, remember these are guys who have never worked civilian medicine and they think it is this easy ,headache free way to become rich- quite the opposite. I listened to their complaints about the army (and the specialists forced into primary care definately DO have a legitimate gripe) but these guys are about to enter a whole new set of headaches , hassles , and lower than expected incomes when they go into civilian medicine. I imagine them complaining just as vociferously in the near future but about a whole different set of problems. I understand the army has a large bureacracy but wait till they meet that beast called "medicare". LOL

 

[drtedjefferson]

Opthomudd. another question, I'm a little ambivalent toward army vs. navy. I have only met with the army recruiter.
Why do you think navy is a better option for docs in the military ?

 

[Andrew_Doan]

I like Navy for several reseasons:

1) Largest medical facilities.

2) Largest medical force because we serve the marines too.

3) You may be required to be on a ship but usually tour of duties are 3 years and can be renewed.

4) I prefer warm tropical climates.

Good luck!

 

[wnkybach]

forced into primary care, etcetera etcetera, remember these are guys who have never worked civilian medicine and they think it is this easy ,headache free way to become rich- quite the opposite. I listened to their complaints about the army (and the specialists forced into primary care definately DO have a legitimate gripe) but these guys are about to enter a whole new set of headaches , hassles , and lower than expected incomes when they go into civilian medicine. I imagine them complaining just as vociferously in the near future but about a whole different set of problems. I understand the army has a large bureacracy but wait till they meet that beast called "medicare". LOL



Two points to make here: It is very easy to be an Army doc and still be intimately familiar with how the civilian side of things works but almost impossible to be in the civilian sector and have clue #1 as to how the military system works.

Second point, without boring you with the details... I have worked both sides. I have my own Medicare/Medicaid numbers, hence I offer my opinions from an informed perspective. It sounds as though you too will soon have this experience.

 

[drtedjefferson]

wnkybach, does the military mistreat it's doctors? are they overworking you because of the shortage they have on docs?. What is your experience? would you, or not, recommend a military medicine career for someone like me?

 

[paean]

Ophtho

I think I read your tax post right (I think it could have two meanings...) But just to be clear, California has sales tax, and what it appeared you talked about later, state income tax. I assume you want to move to the golden state and use another one for resident tax purposes, but if it was the other way around, you'd be out of luck.

 

[wnkybach]

There is a great disparity in the workload of doctors in the Army. Even within the same specialty.


Because of the shortages, the deployments are becoming more and more frequent. It's not just the big deployments that wear on you. They always need docs to go to this 4 week training or that 2-3 month training exercise with their units. I have a good friend that I was in Kuwait with who has been in for 15 years, he broke down one day and told me how he had missed like 10 of his daughters' 14 birthdays because of deployment/training. He was a soldier before going into medicine and truly a soldier at heart. While away, the problem is that you are usually doing diddly squat with medicine, or you are a board certified Internal medicine doc seeing sniffles and twisted ankles.

As far as mistreatment... you are seen by them as a soldier and treated as such according to your rank (oft times begrudgingly in the case of us docs, as discussed previously). Each person feels differently as to whether this is mistreatment or not.

I recommend it only to someone who has always wanted to be a soldier and somewhere along the way decided that maybe medicine would be a good way to quickly advance their career as a soldier.

 

[johnstoner]

so are we all in agreement that military is not a good place for surgeons?