Army Anesthesia? HPSP or no...

[NK1Positive]

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The time is coming when I should decide whether or not to take an Army HPSP scholarship... Can anyone speak on Army Anesthesia programs? Would you honestly recommend going military with this "reform" in progress? Is having no school debt worth the estimated $117,863.16/yr for four years in the Army? Thanks!

 

[narcusprince]

As a Navy Anesthesia resident. I know your numbers are not accurate for salary. By all means do NOT join the military for the money. You will make more and have more control of your practice as a civillian. If you have a strong desire to serve and do not mind getting greased a little during medical school and residency join up.

 

[NK1Positive]

As a Navy Anesthesia resident. I know your numbers are not accurate for salary. By all means do NOT join the military for the money. You will make more and have more control of your practice as a civillian. If you have a strong desire to serve and do not mind getting greased a little during medical school and residency join up.

My number is accurate to the sheet my recruiter gave me... This is post-residency mind you. The question is, will the salaries be as high as they are now 8 years from now to justify my predicted indebtedness of 225k? I doubt they will...

 

[narcusprince]

NK your not breaking down the numbers accordingly. Do you realize BAH, BAS, are nontaxable so those numbers are the same pre and post tax. And what city are you calculating the BAH for? What rank is the salary based at and are you including VSP, BCP, with possible MSP??? PGG maybe you could sound off on the salary thing.

 

[NK1Positive]

NK your not breaking down the numbers accordingly. Do you realize BAH, BAS, are nontaxable so those numbers are the same pre and post tax. And what city are you calculating the BAH for? What rank is the salary based at and are you including VSP, BCP, with possible MSP??? PGG maybe you could sound off on the salary thing.

Captain Base Pay $4722.90 x 12 months =$56,674.80
Housing (based on location yea...) est. $1251.00 x 12 months =$15,012.00
subsistence $223.04 x 12 months = $2676.48
Variable Pay $416.66 x 12 months = $4,999.92
Board Cert Pay $208.33 x 12 months = $2499.96
Total Pay and allowances/yr $81,863.16
Plus specialty pay $36,000 total:$117,863.16

sure it's not all taxed..

 

[narcusprince]

Captain Base Pay $4722.90 x 12 months =$56,674.80
Housing (based on location yea...) est. $1251.00 x 12 months =$15,012.00
subsistence $223.04 x 12 months = $2676.48
Variable Pay $416.66 x 12 months = $4,999.92
Board Cert Pay $208.33 x 12 months = $2499.96
Total Pay and allowances/yr $81,863.16
Plus specialty pay $36,000 total:$117,863.16

sure it's not all taxed..

Its all about what your taxed BAH + BAS is not taxed. Also factor out the 300 large in loans you have to take out for medical school. Add on the fact that most military servicemembers moonlight when stateside. Salaries can approach the 200k range. If your deployed 85k of that money is tax free. Factor in 20 yr retirement with a check for life.

 

[NK1Positive]

Money aside, can you speak well of your experiences?

 

[narcusprince]

I can, I have met some very intelligiat anesthesia residents in the Navy. Granted I am civillian deferred. The attendings in the Navy are excellant, the education curriculum produces very good anesthesiologist. I grew up in the military its all I know and I knew that the day would come when it would be my turn to put on the uniform. I feel the patient population is the best in the world. The work hours are very human most staff work under 40 hrs a week. I am currently training in a civillian institution and feel that respect to patient load the military training may hinder, the staff interactions and support staff brings everything else up. Remember as a civ your a resident nothing more nothing less, in the military you may be a resident but you also have rank and treated as such (respect).

 

[BLADEMDA]

The time is coming when I should decide whether or not to take an Army HPSP scholarship... Can anyone speak on Army Anesthesia programs? Would you honestly recommend going military with this "reform" in progress? Is having no school debt worth the estimated $117,863.16/yr for four years in the Army? Thanks!

What is your cost for four years of Med School? What will the Army be paying for besides tuition? You get a living allowance right?

Did you add those numbers into the $118K listed above? Why not really find out what the Army is doing you for you by adding interest onto those loans you would otherwise need? You may find that your actual salary for 4 years of service is closer to $200K per year plus you can moonlight a little for extra dough.

With Obamacare around the corner I highly recommend this route to anyone on the fence about military medicine. However, for some the military is not and will never be an option. Based on pure economics the military decision for medical school is getting better each year and will be a very, very good deal come 2014.

 

[NK1Positive]

Hm so youre doing a civ. residency through the navy. I wonder how military programs are in general. Lurking around the military med forums, it seems like everyone complains about the lack of "diversity" in the patient base and skill atrophy etc etc. I wonder how much truth there is to that.

 

[NK1Positive]

What is your cost for four years of Med School? What will the Army be paying for besides tuition? You get a living allowance right?

Did you add those numbers into the $118K listed above? Why not really find out what the Army is doing you for you by adding interest onto those loans you would otherwise need? You may find that your actual salary for 4 years of service is closer to $200K per year plus you can moonlight a little for extra dough.

With Obamacare around the corner I highly recommend this route to anyone on the fence about military medicine. However, for some the military is not and will never be an option. Based on pure economics the military decision for medical school is getting better each year and will be a very, very good deal come 2014.

Based on loan calculators i'm looking at about 225k (including interest).. The Army pays full tuition + supplies and $1992 per month during the school year. During residency, this is just what my sheet quotes me, the Army gives $61,372.08 per year. So yes, adding up everything it definitely sounds worthwhile.

Some people love it some people hate it. Another thing I was wondering... What about medical decisions made by higher ranking CRNAs? Is that much of an issue at all?

 

[pgg]

Hello NK1Positive.

There are non-economic risks associated with HPSP, and I'm not talking about the (miniscule) risk of getting shot by some ******* in a foreign dirthole. Chief among the risks are delays in training, limited residency options, and an overall trend toward downsizing and outsourcing which hurts both GME and attending workload.

Do you know what a GMO tour is? How old are you?

Your salary figures are about right for someone who does internship/residency without a GMO delay.

The milmed forum is a better place to ask about these issues. The general tone there is pretty negative, but overall I've personally been happy with the Navy. I was USUHS not HPSP though.

It's looking more and more like I won't stay in the Navy beyond my commitment, simply because the fellowship and cases I want to do really aren't needed in the military.

Another thing I was wondering... What about medical decisions made by higher ranking CRNAs? Is that much of an issue at all?

No, it hasn't come to that. While CRNAs are fully credentialed independent providers of anesthesia in the military, for the most part they do their cases and you do yours. Very very few are anything like the militant obnoxious tool CRNAs who tend to post on this forum. Clinically speaking, rank is a non-issue, and I say that as an O-4 MD who answers to an O-5 CRNA anesthesia department head out at Podunkville Naval Air Station. She does have a nicer office than me, but I think I might steal it while she's deployed. Possession is 9/10ths of the law, you know. 🙂

 

[psychbender]

Army anesthesiology intern here, PM me.

 

[pgg]

I will add that while you're a resident CRNAs are considered "staff" and the overall tenor of the relationship is very different than it seemed to be between civilian residents & CRNAs at other institutions. Direct interactions are few and CRNAs never teach or supervise residents, but they are still "staff" and even friendly gets-along-with-everybody mild-mannered pgg had a few run-ins with particular CRNAs doing things they shouldn't have been doing. But maybe that's just residency.

 

[NK1Positive]

Hey Pgg thanks for the info!

Do you know what a GMO tour is? How old are you?

I am aware of the GMO tours... Everyone is telling me GMO tours arent as common in the Army as other branches of the military but I honestly have no idea; that's one thing that makes me wary. I'm only 21 but i'd still rather go straight through.. My recruiter makes it sound like you can set yourself up with programs pretty nicely but what do they really know?

I've been talking with the BAMC PD and the program seems to be pretty solid.

 

[pgg]

Everyone is telling me GMO tours arent as common in the Army as other branches of the military but I honestly have no idea

That is true, but your odds of doing a GMO tour as a civilian are approximately 0%.

And every premed plans on being that 4.0 med student who'll have his pick of competitive residencies ... but there's still the possibility that you'll find yourself applying for one of ~30 (?) competitive Army anesthesia spot when you're not even eligible to apply for 1000+ civilian spots.

My recruiter makes it sound like you can set yourself up with programs pretty nicely but what do they really know?

You can if you're a 4.0 student with 250 USMLE scores.

I've been talking with the BAMC PD and the program seems to be pretty solid.

Military anesthesia programs are solid, and they probably will remain so for the foreseeable future.

But one more thing to consider - most premeds change their minds about the field they choose. You may be locked on to anesthesia today, and it really is the One True Specialty all other sane doctors wish they'd chosen if they'd had our foresight, but you might fall in love with rad onc or ENT or pulmonology-critical-care or god forbid surgery. The pool of available residency slots is smaller and less diverse in the military.

HPSP obligates you to apply for a military residency ... or do a 4-year GMO payback after internship and then chase a civilian residency position when you get out.

I'm not trying to talk you out of HPSP (though I think FAP is a safer option) but these are issues to be aware of.

 

[WholeLottaGame7]

That is true, but your odds of doing a GMO tour as a civilian are approximately 0%.

And every premed plans on being that 4.0 med student who'll have his pick of competitive residencies ... but there's still the possibility that you'll find yourself applying for one of ~30 (?) competitive Army anesthesia spot when you're not even eligible to apply for 1000+ civilian spots.
HPSP obligates you to apply for a military residency ... or do a 4-year GMO payback after internship and then chase a civilian residency position when you get out.

I'm not trying to talk you out of HPSP (though I think FAP is a safer option) but these are issues to be aware of.

I strongly considered HPSP before backing out due mostly to these exact concerns, most of which I gleaned from an AF anesthesia resident doing a civilian deferment, since the recruiter was most unhelpful.

I ultimately decided that having the flexibility to have a (better) choice of what/where I wanted to do residency was more important than having the military pay for med school. I've always wanted to

I would definitely look into the FAP, I am considering that vs just joining after residency (my situation is complicated by a wife doing a residency of a different length...)

 

[NK1Positive]

pgg you make some great points. My best option is probably to go the civilian route. I change my mind everyday and reading about how everything is "going downhill" is a little bit scary if you know what I mean. The military seems to offer some "stability", but I dont really know what I am talking about... Thanks so much for all the help!

 

[bogatyr]

That is true, but your odds of doing a GMO tour as a civilian are approximately 0%.

And every premed plans on being that 4.0 med student who'll have his pick of competitive residencies ... but there's still the possibility that you'll find yourself applying for one of ~30 (?) competitive Army anesthesia spot when you're not even eligible to apply for 1000+ civilian spots.

12 anesthesiology positions per year in the army. This year there were about that many applicants due to the lean years in the HPSP program. By the time you are applying there will be more applicants applying for the same number of positions, so you may have to do a GMO tour or pick another specialty. The army sends 0 people to civilian residencies (in anesthesiology).

I don't think it has been made sufficiently clear to you. Don't do it for the money. Do you think the 20,000 medical students that don't take the HPSP each year are homeless and starving? No, they do just fine. Especially the ones that go into anesthesiology. The money is nice as a medical student and resident, but when you sell your soul to the devil he always comes to collect. Also, many posters above off-handedly say "just moonlight" to increase your salary as an attending. I am not allowed by my commander to moonlight.

 

[NK1Positive]

I don't think it has been made sufficiently clear to you. Don't do it for the money.

I completely understand, if I do join, it would definitely not be for the money. I know a few people who have gone through the Army, specifically ophthalmo, IM, and FP, and have had great experiences.

Also, many posters above off-handedly say "just moonlight" to increase your salary as an attending. I am not allowed by my commander to moonlight.

People not being allowed to moonlight is something I have heard about. Thanks for bringing it up though. Often times the little details are buried amongst the larger ones.

 

[BLADEMDA]

I completely understand, if I do join, it would definitely not be for the money. I know a few people who have gone through the Army, specifically ophthalmo, IM, and FP, and have had great experiences.



People not being allowed to moonlight is something I have heard about. Thanks for bringing it up though. Often times the little details are buried amongst the larger ones.

Why Army and not Navy? I did my Residency with a great guy who owed the Navy time. He is now in PP and doing well.

 

[pgg]

Why Army and not Navy? I did my Residency with a great guy who owed the Navy time. He is now in PP and doing well.

In the Navy, more than 2/3rds of all physicians are required to serve a GMO tour, which is a 2-3 year delay between PGY1 and PGY2. For anesthesia, nearly 100% will have this delay. I spent 3 years with Marine infantry (14 months of which I was in Iraq or Afghanistan) before I was able to go back and finish residency.

GMO delays are far less common in the Army and Air Force.

 

[narcusprince]

12 Also, many posters above off-handedly say "just moonlight" to increase your salary as an attending. I am not allowed by my commander to moonlight.

Bogatyr, are you a staff in the Army, Navy, Air Force. As a medical student when I rotated at each of the Navy hospitals moonlighting was encouraged. And with the few contacts I know throughout the Navy moonlighting is encouraged.

 

[Monty Python]

In the Navy, more than 2/3rds of all physicians are required to serve a GMO tour, which is a 2-3 year delay between PGY1 and PGY2. For anesthesia, nearly 100% will have this delay. I spent 3 years with Marine infantry (14 months of which I was in Iraq or Afghanistan) before I was able to go back and finish residency.

GMO delays are far less common in the Army and Air Force.

As background, I'm currently recalled to Navy active duty from the reserves, assigned to the Army hospital in Germany. We get the poor SOBs injured downrange.

A few weeks ago the commanding officer (a one star admiral) of Naval Medical Center Portsmouth passed this way and held an All-Hands meeting. During the Q+A I asked him about medical/dental/nursing recruiting and retention statistics. He did not know that I'm a Professional Schools Liaison Officer (a local resource to HPSP students in my state) and that I routinely receive manning updates from BUMED.

He said that both recruiting and retention are excellent. 🙄 I replied that the Navy had left almost 50% of their HPSPs on the table several years running, as these internet forums had let medical students in on the Navy's nasty little secret of the GMO tour. He replied that the Navy was doing everything possible to get away from the GMO tour, as it's under fire from several important Senators to do so. In the same breath he said that the Navy's forward deployed mission is best designed to be manned by post-intern, pre-resident GMOs. I guess flip a coin and take your chances.

 

[militarymd]

As background, I'm currently recalled to Navy active duty from the reserves, assigned to the Army hospital in Germany. We get the poor SOBs injured downrange.

A few weeks ago the commanding officer (a one star admiral) of Naval Medical Center Portsmouth passed this way and held an All-Hands meeting. During the Q+A I asked him about medical/dental/nursing recruiting and retention statistics. He did not know that I'm a Professional Schools Liaison Officer (a local resource to HPSP students in my state) and that I routinely receive manning updates from BUMED.

He said that both recruiting and retention are excellent. 🙄 I replied that the Navy had left almost 50% of their HPSPs on the table several years running, as these internet forums had let medical students in on the Navy's nasty little secret of the GMO tour. He replied that the Navy was doing everything possible to get away from the GMO tour, as it's under fire from several important Senators to do so. In the same breath he said that the Navy's forward deployed mission is best designed to be manned by post-intern, pre-resident GMOs. I guess flip a coin and take your chances.

almost as good as:

- the check is in the mail

and

- I promise....I won't c*m in your mouth

 

[pgg]

He replied that the Navy was doing everything possible to get away from the GMO tour, as it's under fire from several important Senators to do so.

Yeah, they told me the same thing when I was applying to medical school. In 1997.

They actually have made some progress in converting GMO billets to BC-physician billets ... but the HPSP shortfall you mentioned has put a huge dent in that plan. This year's GME2+ match was disappointing to a lot of interns who were expecting progress.

 

[nyc.student]

Army anesthesiology intern here, PM me.

Can you outline the procedure for becoming an anesthesiologist in the army? Also the pay.
And will I be required to fight?

 

[imfrankie]

I was in the Army, albeit as an enlisted grunt. It sucked.

 

[psychbender]

Can you outline the procedure for becoming an anesthesiologist in the army? Also the pay.
And will I be required to fight?

Dude, check out the Military Medicine forum, and read the stickies about HPSP.

In short, you get into med school, apply for and sign an HPSP contract with the Army, match into one of the two Army anesthesiology residencies during your MS4 year, complete residency, then enter your payback period as a staff anesthesiologist. If during the payback period we are actively involved in a conflict in another country, it is quite possible that you will be selected to deploy in support of our mission there. While deployed, you are an anesthesiologist, not a trigger-puller, so you are unlikely to be "required to fight."

As for pay, think 1/4 - 1/3 market rate during your payback years.