Army Doctor

[mgrey52]

If I decide I want to join the military to become a doctor could they help me pay for college? How long would I be required to serve?

---

Members don't see this ad.

 

[notdeadyet]

Read the stickies. Particularly, read the one entitled "HPSP, USUHS, FAP threads."

After you've done that, if you have specific questions, please feel free to come back and post them.

 

[pgg]

If I decide I want to join the military to become a doctor could they help me pay for college? How long would I be required to serve?

The mechanisms by which the military might pay for college (undergrad) tend to be unhelpful or even counterproductive for doctor wannabes.

The academies and ROTC exist to produce line officers, not doctors. If you finish up undergrad owing the military anything, you may have difficulty getting the OK to head straight to medical school. Don't take the military's money for undergrad unless you want to be a line officer.

Not to mention, it's probably unwise for a high school grad to sign up for a military commitment as a doctor that won't be served until 15-20 years later. Nobody, but nobody, has any idea what the world and military medicine will look like then.


Go to an inexpensive state/public university, pay for it with work study / scholarships / loans, get a degree with the pre-med prerequisites done, get into medical school, and then figure out how to get medical school paid for.

I.e., do what 98% of people have done for the last five or six decades.

 

[Gastrapathy]

If he does what 98% of people do, he will stop being premed by halfway thru soph year.

 

[pgg]

If he does what 98% of people do, he will stop being premed by halfway thru soph year.

Well ... yeah, but ... I think we're supposed to be nurturing and encouraging, or something.

 

[Shikima]

Well ... yeah, but ... I think we're supposed to be nurturing and encouraging, or something.

Nurture damn you! NURTURE!

 

[Gastrapathy]

Sorry. On a ski trip with a OChem prof at an Ivy and his stories are killing me.

 

[militarygirl]

I'm interested in something similar to what OP posted. What are the chance of me getting an educational delay after undergrad? For example; I can do undergrad at local university and ROTC for all four years (w/ contract between Soph-Jr yrs). Then I'd apply to USUHS (first choice). If I get in to USUHS, can I get an educational delay? If not, what would I do in between?
I don't mind the payback years because I plan on serving for a long time anyway in the long-run.

 

[pgg]

I'm interested in something similar to what OP posted. What are the chance of me getting an educational delay after undergrad? For example; I can do undergrad at local university and ROTC for all four years (w/ contract between Soph-Jr yrs). Then I'd apply to USUHS (first choice). If I get in to USUHS, can I get an educational delay? If not, what would I do in between?
I don't mind the payback years because I plan on serving for a long time anyway in the long-run.

This is a terrible idea for all the reasons I mentioned in my post above.

If you want to be a line officer, take the military's money for college.

If you want to be a doctor, don't.

 

[militarygirl]

Okay, so you're saying no ROTC in college. In that case, after I finish my undergrad degree(focusing only on school, with no ROTC), would it be wise to do USUHS and go from there?

How did you, personally, become a physician in the Navy and what do you do there?

 

[pgg]

There's a long list of pros/cons to USUHS in the stickies. Too much to quickly summarize.

I went to USUHS after undergrad at a state school. Undergrad was financed with a small amount of student loans, but mostly by mooching off my parents. I'm an anesthesiologist and I work in a hospital.

 

[j4pac]

Don't go into the military for the money...it's a mistake for many reasons, including more often than not, financial.

 

[deleted480308]

military girl, I think part of the problem is that when you are a kid in your twenties who has never had a career and you look at the potential $300k in med school debt it looks so expensive that you'll sell your soul to anyone who will save you from it. And yeah, it's a lot of money, almost too much debt to imagine. But at your stage in life, a doctor's salary is also so much it's almost imaginary. You'll be able to pay back the loans without the military money. So evaluate it from a position of knowing it's doable without the military. Maybe you just really want to be in or the timing of that stipend is really important to you for some reason.....cool, then you are making an informed decision.

But too many people make that call from a factually incorrect fear that they'll never be able to pay the bill.

 

[HighPriest]

Wow. sb247's post is so close to spot-on accurate that I think he's been reading some diaries. I think a LOT of people sign up for HPSP because of that exact situation.

I had a few reasons to join beyond the financial, but unquestionably part of the reason was exactly what he had said - especially if you come from a background where no one in your family is a physician. I make more money than anyone else in my family in the military - let alone once I'm out. So the idea of making hundreds of thousands of dollars per year was no more real to me than reading it on drudgereport.

Trust me, and sb247, when I say that you will pay back your loans no matter what you do. Medical school loans are large, but this is not the same kind of student debt that you hear about all the time on the news. Those are people who spent 6 years in college getting a degree in bull$#!T so that they could move back in with their parents and get an entry level job as a telemarketer. We have definitely screwed our society by making it more or less essentially for any moderately-well paying job to have some kind of college education, but med school debt falls into a different category because after your training you're very, very likely to fall into a high-paying job, many of which have loan-repayment options. It's apples and oranges.

It's anecdotal, but two weeks ago I spoke with the wife of one of my colleagues. He's HPSP, she's civilian, both surgeons. He's slogging through the same crap that I am. She landed a job in the same town at a small hospital associated with a medical school. She takes no call. None. She makes twice what he does. She has to stay there for four years, and they repay her loans 100%. She has the research capabilities of the larger institution at her disposal, free resident labor, they feed her cases with a lot of autonomy in terms of what she wants to do. The catch: she's in a moderately sized city (not the boon docks, not Manhattan) and she makes less than she might in private practice - but still way more than I do. Yes, this is anecdotal, but for whatever it's worth they had trouble filling her position. She's been waiting for the unknown catch for 2 years now, and that preverbal hammer has not fallen. There are options out there.

 

[j4pac]

sb and highpriest...so much win.

OP...if you are really concerned about the loans...do some research on the topic. The White Coat Investor is (in my opinion) the best physician financial book and website in existence. I would at the very least read the following blog...
http://whitecoatinvestor.com/personal-finance/should-i-join-the-military-to-pay-for-medical-school/

HalfMD also put together a comparison of net worth...
https://halfmd.wordpress.com/2007/0...f-the-health-professions-scholarship-program/

Many members have also put together similar comparisons on this forum...and they all point to HPSP being a poor choice for the money (and an alarmingly poor choice for someone going into something other than primary care).

Get into med school...go the civilian route...become educated on loan forgiveness vs private loan consolidation and paying off quickly...and you will be absolutely fine. Don't go into the military unless you are set on being a military physician.

 

[TheEarDoc]

Loans will be easily paid back in the medical field. Now if you go into other professions not so much. Take mine for instance. It's a little harder to pay back even 60k in loans when you make a base salary in the mid 70's for the government.

Do not have Uncle Sam pay for your undergrad. You can afford it and if you have the grades/smarts to be pre-med material then most likely you will qualify for some scholarships at most state schools! Get your undergrad degree in pre-med then if you are still pre-med when you graduate (trust me most won't be!) and get accepted to medical school then you can go to Uncle Sam for assistance with school if you still want to go that route. Most people see the commitment required for the monies from Uncle Sam and decide they will just take the loans, then work a job somewhere and moonlight somewhere else for a couple years until they pay back their loans.

 

[DD214_DOC]

I cry a little every night knowing my civilian counterparts are earning $100,000 or more a year for doing the same thing I'm doing. It's a tad demoralizing.

 

[TheEarDoc]

I cry a little every night knowing my civilian counterparts are earning $100,000 or more a year for doing the same thing I'm doing. It's a tad demoralizing.

Try knowing someone with a GED, no STD's, and a state licensure is allowed to do your same job in most states and then talk to me about being demoralized....

 

[Chonal Atresia]

I cry a little every night knowing my civilian counterparts are earning $100,000 or more a year for doing the same thing I'm doing. It's a tad demoralizing.

Ditto this!

My K-1 this past year was around $500K more than my last W-2 in the military (including tax free BAH/BAS). Granted, I am a surgical sub-specialist but even as a primary care doc your pay is like to be near $100K/yr more as a civilian.

Take out loans and stay away unless you really want to be a career military physician.

 

[Red Lobster Actual]

Ditto this!

My K-1 this past year was around $500K more than my last W-2 in the military (including tax free BAH/BAS). Granted, I am a surgical sub-specialist but even as a primary care doc your pay is like to be near $100K/yr more as a civilian.

Take out loans and stay away unless you really want to be a career military physician.

my peasant mind and humble background cannot even comprehend that amount of money Dr. Chonal. Good to hear you are on greener pastures! Much much greener...

I was under the impression primary care pay in the military is reasonably competitive?

average ~$200k/year for PCP according to Medscape Physician Compensations Report 2015

~$150,000/year gross accounting for the tax advantage of BAH (San Antonio locale) & BAS for military PCP in family medicine, fresh out of residency (O-3 w/ 3 years TIS), board certified, VSP, ASP, ISP. Single.

And then after HPSP obligation is done.

~$180,000/year gross as O-4 w/ 7 years TIS without MSP (+ ~$25,000 (??) w/ MSP). Married w/ wife and 2 children.

But to hit average PCP pay and still having to deal with the military stuff...

 

[Chonal Atresia]

my peasant mind and humble background cannot even comprehend that amount of money Dr. Chonal. Good to hear you are on greener pastures! Much much greener...

I was under the impression primary care pay in the military is reasonably competitive?

average ~$200k/year for PCP according to Medscape Physician Compensations Report 2015

~$150,000/year gross accounting for the tax advantage of BAH (San Antonio locale) & BAS for military PCP in family medicine, fresh out of residency (O-3 w/ 3 years TIS), board certified, VSP, ASP, ISP. Single.

And then after HPSP obligation is done.

~$180,000/year gross as O-4 w/ 7 years TIS without MSP (+ ~$25,000 (??) w/ MSP). Married w/ wife and 2 children.

But to hit average PCP pay and still having to deal with the military stuff...

Use MGMA guidelines to determine percentiles - MUCH more accurate than Medscape. I think you'll find PCPs well above 200K.

 

[DD214_DOC]

The prior numbers are a bit off. O3 with 5 tis is about 130k gross. O4 with 6 bumps up to 147k. Another problem I wish I knew before signing is that a huge chunk of our income is our lump sum special pays. Many financial institutions will exclude these because they get treated like bonuses. It can take a lot of work and documentation to prove otherwise and even then doesn't always work.

My exact position is being advertised for a civilian for 310k per year and even with that nobody wants it as its gone vacant for about 5 years for various reasons. Imagine making less than half that amount with the additional workload from the mandatory military stuff and you'll understand why so many say that hpsp isn't worth it. Oh yeah, plus the restrictions on moonlighting and needing permission from command to even do it.

 

[Perrotfish]

The prior numbers are a bit off. O3 with 5 tis is about 130k gross. O4 with 6 bumps up to 147k. Another problem I wish I knew before signing is that a huge chunk of our income is our lump sum special pays. Many financial institutions will exclude these because they get treated like bonuses. It can take a lot of work and documentation to prove otherwise and even then doesn't always work.

My exact position is being advertised for a civilian for 310k per year and even with that nobody wants it as its gone vacant for about 5 years for various reasons. Imagine making less than half that amount with the additional workload from the mandatory military stuff and you'll understand why so many say that hpsp isn't worth it. Oh yeah, plus the restrictions on moonlighting and needing permission from command to even do it.

Again, I don't think people really understand compound interest all that well, which is both why so many students keep signing up for these loans and why so many military doctors keep thinking they're being screwed.

Paying your way through an average private school these days costs about 300K with minimal living expenses, but that's not what you pay. The loans compound to about 500K at the end of medical school and a 3 year residency, but that's not what you pay either. They keep compounding throughout your payback, so if you pay the whole thing off in 10 years what you pay is 750K, But that's not what you have to earn. You pay the money back with after tax dollars, so you need to earn 1.5 times as much, or about 1.1 million. Add on the military tax advantage, the stipend during medical school, and the extra pay during residency and the civilian physician needs to make 1.3 million a year extra during the 4 years of HPSP payback just to break even. The extra 150K you could be making as a civilian for your exact position doesn't even come close to that.

Is it possible to make 320K/year more in the military than as a civilian? For the highest paid surgical subspecialists, yes. For 95% of physicians no. And again, that's just to break even. Getting screwed by the HPSP scholarship means that you're making way more than an extra 320K more than the military physician, which means a salary north of 600K. Those are pretty rare, even in medicine.

 

[TheEarDoc]

Again, I don't think people really understand compound interest all that well, which is both why so many students keep signing up for these loans and why so many military doctors keep thinking they're being screwed.

Paying your way through an average private school these days costs about 300K with minimal living expenses, but that's not what you pay. The loans compound to about 500K at the end of medical school and a 3 year residency, but that's not what you pay either. They keep compounding throughout your payback, so if you pay the whole thing off in 10 years what you pay is 750K, But that's not what you have to earn. You pay the money back with after tax dollars, so you need to earn 1.5 times as much, or about 1.1 million. Add on the military tax advantage, the stipend during medical school, and the extra pay during residency and the civilian physician needs to make 1.3 million a year extra during the 4 years of HPSP payback just to break even. The extra 150K you could be making as a civilian for your exact position doesn't even come close to that.

Is it possible to make 320K/year more in the military than as a civilian? For the highest paid surgical subspecialists, yes. For 95% of physicians no. And again, that's just to break even. Getting screwed by the HPSP scholarship means that you're making way more than an extra 320K more than the military physician, which means a salary north of 600K. Those are pretty rare, even in medicine.

Which is why if the government really wanted to solve the student loan crisis it would be an easy fix. Make student loans directly removed from paychecks pre-tax. This would mean the government gets their loans with interest paid back, and the people on an income based payment plan can actually pay a realistic loan repayment! IF you look at my gross income (which is what the loan company uses to determine my income based repayment plan amount per month) it looks like I am making great money. If you looked closer you would see by the time they remove retirement, my healthcare premiums since I am the insurance carrier for our family, taxes, medicare tax, etc. I take home roughly 55-60% of my gross salary that the loan folks are basing my payment off of. It's idiotic.

I would gladly let them take the payment pre-tax, lower my tax bracket, and thus drop myself into a lower and more realistic student loan repayment amount per year. Also since you can only claim $2500 for tax credit per year for student loan repayment, when you are paying 6-10k back per year just in loan repayment it still screws you.

I figured out a long time ago your best bet is to disown your children at 18 and let them go to school because they own nothing, make nothing, and qualify for all the grants.

 

[Ziehl-Neelsen]

Again, I don't think people really understand compound interest all that well, which is both why so many students keep signing up for these loans and why so many military doctors keep thinking they're being screwed.

Paying your way through an average private school these days costs about 300K with minimal living expenses, but that's not what you pay. The loans compound to about 500K at the end of medical school and a 3 year residency, but that's not what you pay either. They keep compounding throughout your payback, so if you pay the whole thing off in 10 years what you pay is 750K, But that's not what you have to earn. You pay the money back with after tax dollars, so you need to earn 1.5 times as much, or about 1.1 million. Add on the military tax advantage, the stipend during medical school, and the extra pay during residency and the civilian physician needs to make 1.3 million a year extra during the 4 years of HPSP payback just to break even. The extra 150K you could be making as a civilian for your exact position doesn't even come close to that.

Is it possible to make 320K/year more in the military than as a civilian? For the highest paid surgical subspecialists, yes. For 95% of physicians no. And again, that's just to break even. Getting screwed by the HPSP scholarship means that you're making way more than an extra 320K more than the military physician, which means a salary north of 600K. Those are pretty rare, even in medicine.

Perrotfish gets it. My old private medical school now costs >50k per year for tuition (~30k when I was a student a decade ago). Interest on medical student loans is generally no longer tax deductible (like it was when I was a medical student) when you are an attending and able to start paying it off. The rule of 72 is undefeated and untied. There's a reason that Albert Einstein is purported to have called compound interest the "most powerful force in the universe".

HPSP is actually a good financial deal in the current climate during the initial payback--pretty much regardless of medical subspecialty (unless you are ortho spine, neurosurgery, or the like). The financial decision about whether or not to stay in past your initial commitment is far more relative and dependent on subspecialty, years toward the pension, etc.

Money is not the reason to eschew HPSP, it's the stuff the military can do to you (that most pre-meds have no clue about) after you take the money that should be the reason to evaluate HPSP so critically. Deployments, loss of geographic control for your family, chance you won't match your desired specialty, residency quality, GMO tours that surreptitiously extend your military commitment, skill atrophy, the "unique" aspects of military culture and authority, etc. These are the things that people need to carefully consider before signing up. The only real question people need to consider when deciding on HPSP is whether the money is worth the loss of autonomy. And the answer to that question is highly variable as evidenced by the varying opinions on this board.

 

[WernickeDO]

Money is not the reason to eschew HPSP, it's the stuff the military can do to you (that most pre-meds have no clue about) after you take the money that should be the reason to evaluate HPSP so critically. Deployments, loss of geographic control for your family, chance you won't match your desired specialty, residency quality, GMO tours that surreptitiously extend your military commitment, skill atrophy, the "unique" aspects of military culture and authority, etc. These are the things that people need to carefully consider before signing up. The only real question people need to consider when deciding on HPSP is whether the money is worth the loss of autonomy. And the answer to that question is highly variable as evidenced by the varying opinions on this board.

Someone sticky this please.

Add also the strain it can put on your family, be they sacrifices to your spouses career or deployments/trips to NTC/JRTC/CCC.

 

[notdeadyet]

Paying your way through an average private school these days costs about 300K with minimal living expenses, but that's not what you pay. The loans compound to about 500K at the end of medical school and a 3 year residency

That math might be off. Assuming a disbursement of $75K/year annually over four years with an interest of 6.8%, you'd owe $431K by the end of medical school and a three year residency.

HPSP can be a good financial deal for some, but whenever folks try to make this case, I notice that they tend to hedge things in the favor of their arguments.

If you want to make the case for HPSP for the debt averse applicant, why on earth would you assume someone wouldn't pay any student loans during residency? You can easily knock off $20-30K from your debt during residency without much effort. If you're aggressive about moonlighting, you can do a LOT more than that. Earning an extra $75K with one weekend moonlighting gig through residency is not too much of a challenge for many. Even busy specialties have folks can tamp down a good bit of debt if they work hard. I do a lot better than that and I still drill every month. If you care about your debt, you don't watch it accumulate during residency.

I agree with you that HPSP is a better financial bet than not taking HPSP, but only with a few key assumptions:

• The applicant goes to a high cost medical school
• The applicant would defer payments on his/her student loans through residency without moonlighting
• The applicant does not seek out post-residency work that has a loan repayment scheme
• The applicant does not take PSLF that wipes out their debt 10 years later (I definitely would make this assumption, as I'm not confident it'll be around for long)
• The applicant ends up in a specialty in which the salary differential between military and civilian is not significant.

But applicants need to realize that once they say NO to one, a couple, or a few of those assumptions, HPSP rapidly becomes cost ineffective.

 

[Chonal Atresia]

Again, I don't think people really understand compound interest all that well, which is both why so many students keep signing up for these loans and why so many military doctors keep thinking they're being screwed.

Paying your way through an average private school these days costs about 300K with minimal living expenses, but that's not what you pay. The loans compound to about 500K at the end of medical school and a 3 year residency, but that's not what you pay either. They keep compounding throughout your payback, so if you pay the whole thing off in 10 years what you pay is 750K, But that's not what you have to earn. You pay the money back with after tax dollars, so you need to earn 1.5 times as much, or about 1.1 million. Add on the military tax advantage, the stipend during medical school, and the extra pay during residency and the civilian physician needs to make 1.3 million a year extra during the 4 years of HPSP payback just to break even. The extra 150K you could be making as a civilian for your exact position doesn't even come close to that.

Is it possible to make 320K/year more in the military than as a civilian? For the highest paid surgical subspecialists, yes. For 95% of physicians no. And again, that's just to break even. Getting screwed by the HPSP scholarship means that you're making way more than an extra 320K more than the military physician, which means a salary north of 600K. Those are pretty rare, even in medicine.

MANY specialties can make north of 600K (private practice, not hospital employed) if you are willing to push hard in clinic, OR, etc.

I am in a moderate-sized city in the southeast US. The orthopods, urologists, neurosurgeons, GI guys, cardiologists and bariatric surgeons all routinely hit this benchmark. Hell, our spine guy made nearly $3M last year!

My point is the money is there if you're willing to work hard and not live in Manhattan, San Francisco, etc.

 

[Shikima]

MANY specialties can make north of 600K (private practice, not hospital employed) if you are willing to push hard in clinic, OR, etc.

I am in a moderate-sized city in the southeast US. The orthopods, urologists, neurosurgeons, GI guys, cardiologists and bariatric surgeons all routinely hit this benchmark. Hell, our spine guy made nearly $3M last year!

My point is the money is there if you're willing to work hard and not live in Manhattan, San Francisco, etc.

That's specialty dependent and what the reimbursement rates are. Not many paying premium cash prices. For me seeing 20 per day in clinic (because of late cancels and no shows) and at 4 days per week, I'll be between 200-250k.

 

[Chonal Atresia]

That's specialty dependent and what the reimbursement rates are. Not many paying premium cash prices. For me seeing 20 per day in clinic (because of late cancels and no shows) and at 4 days per week, I'll be between 200-250k.

I see 40-45 on average and work 5 days per week, so double that amount you are making by working more.

That's the beauty of capitalism and the downfall of socialistic medicine in the military, you can work as much as you want (within reason) and you are compensated accordingly. I will give you that you (or I) will never make what a spine surgeon makes.

 

[Shikima]

I see 40-45 on average and work 5 days per week, so double that amount you are making by working more.

That's the beauty of capitalism and the downfall of socialistic medicine in the military, you can work as much as you want (within reason) and you are compensated accordingly. I will give you that you (or I) will never make what a spine surgeon makes.

Procedures always pay. Talking doesn't.

 

[Ziehl-Neelsen]

HPSP can be a good financial deal for some, but whenever folks try to make this case, I notice that they tend to hedge things in the favor of their arguments.

Not necessarily. If you don't buy Perrotfish's assessment, check out Jim's:
http://whitecoatinvestor.com/personal-finance/should-i-join-the-military-to-pay-for-medical-school/

His numbers indicate that an EM physician who took an HPSP scholarship comes out of payback with total financial benefits of 1.125 million while the EM physician who used loans comes out with total benefits of 1.083 million for a difference of 42k in favor of the physician who took HPSP. And that is with some assumptions that I consider heavily in favor of the civilian route. He assumes no outstanding loans from undergrad. He assumes yearly medical school loan distributions of 48k which ain't happening for private medical schools and is low even for many public schools as numerous state university medical schools sport tuition >30k. He assumes a 3 year residency that results in an average salary of 263k (not many medical specialties where a 3 year residency and no fellowships results in an average salary of 263k). He assumes that the military staff physician does not supplement his military income with moonlighting.

You can easily knock off $20-30K from your debt during residency without much effort. If you're aggressive about moonlighting, you can do a LOT more than that. Earning an extra $75K with one weekend moonlighting gig through residency is not too much of a challenge for many.

That's a pretty aggressive assumption that one could average 25k per year with a weekend moonlighting gig during residency in order to pay down debt. First of all, you generally can't start moonlighting until after internship and procurement of a medical license. Secondly, where does all this time to moonlight as a resident come from. My wife averaged 64 hours per week during her IM residency with 4 ward months per year (q5 call) and 2 ICU months per year (q3 call). If you're spending all your free time as a resident moonlighting, when do you work on a paper/research project or read to improve your medical knowledge? Hell, when do you go for a run, take a weekend getaway with your significant other, attend your sister's destination wedding, or spend time with your kid(s)?

• The applicant does not seek out post-residency work that has a loan repayment scheme

• The applicant does not take PSLF that wipes out their debt 10 years later (I definitely would make this assumption, as I'm not confident it'll be around for long)

I agree that these factors would definitely tilt the calculus in favor of taking loans, but again, its a pretty big assumption that these options will be available for every physician who would utilize them to eliminate debt.

If you care about your debt, you don't watch it accumulate during residency.

I also agree with this. If I had taken out loans, I would have led a very meager existence during residency because my dad taught me the rule of 72 when I was 12. But as it is, my wife and I were able to pay for our wedding, pay for a Caribbean honeymoon, take a modest trip to Europe, have a child, and attend the far-flung meaningful events of family and friends (weddings, funerals, ordinations, etc.) while residents and still be slightly financially ahead of where we would have been at the end of our initial commitment had we taken loans.

There are many reasons not to take the HPSP scholarship that I and others have chronicled ad infinitum on this forum. But in the present reality, for 75% or so of medical students, the financial situation of a physician who takes HPSP and repays his initial commitment is not one of those reasons.

 

[notdeadyet]

Not necessarily. If you don't buy Perrotfish's assessment, check out Jim's:
http://whitecoatinvestor.com/personal-finance/should-i-join-the-military-to-pay-for-medical-school/

I'm curious on the specifics of how he's coming up with his "total financial benefits" for the numbers he's running, but I agree with his overall assessment, which is:

The balance is tilted in favor of the civilian route for a cheaper medical school, cheaper loans, a higher-paying specialty, or a more lucrative private partnership type position. Conversely, the balance is tilted in favor of the military route for a more expensive medical school, a lower paying specialty, or prior military service.

Hard to argue with that.

There are many reasons not to take the HPSP scholarship that I and others have chronicled ad infinitum on this forum. But in the present reality, for 75% or so of medical students, the financial situation of a physician who takes HPSP and repays his initial commitment is not one of those reasons.

I don't know anything about the 75% or where that comes from, but I do know that HPSP is and will depend on a bunch of variables that each applicant needs to consider before saying it's a good financial deal or a bad one. Arguments about whether it's a good investment or a bad investment is so user-dependent as to make any generalizations to be unhelpful. That's why I object to assertions that HPSP is a "great deal." Whole bunch of assumptions need to be made for that to be anywhere close to true.

Folks need to run their own numbers to see if it makes sense for them. They need to know a whole bunch of variables that they do not know by the time they apply for and sign the contract for HPSP. For instance, the second biggest variability for whether or not HPSP is a good investment is specialty choice, and despite the confidence of every applicant, a majority of folks end up in a different specialty than the one they had in mind when they started (not by much, but still a slight majority).

And that is my big objection to HPSP. Whether or not it's a good decision relies quite a bit on luck. And betting on luck is a bad investment.

 

[notdeadyet]

There's also an element of bias in these discussions that is very hard to get around. Folks who argue strongest for what a great deal HPSP is are folks who have signed up for it and folks who argue strongest against what a great deal HPSP is are folks who have considered it and rejected it. And both parties have a very vested interest in believing they were right (sweet lemons vs. sour grapes).

 

[Gastrapathy]

There's also an element of bias in these discussions that is very hard to get around. Folks who argue strongest for what a great deal HPSP is are folks who have signed up for it and folks who argue strongest against what a great deal HPSP is are folks who have considered it and rejected it. And both parties have a very vested interest in believing they were right (sweet lemons vs. sour grapes).

Lots of people who tasted the grapes have a negative opinion too.

 

[DD214_DOC]

Whoa, I've missed quite a bit in a short amount of time.

I will say that what's written above isn't necessarily true. I think there are many more who chose to do HPSP for whatever reasons, only to discover that they made such a huge decision without a lot of information or really understanding how things are. The system itself is very frustrating and only getting worse, but that's another discussion. I have actually enjoyed most of my experience so far, but had I known what I know now, my decision would have likely gone another way.