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Army HPSP and options for getting OUT

Discussion in 'Medical Students - MD' started by lambeufl, Nov 7, 2002.

  1. lambeufl

    lambeufl Junior Member

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    I have a serious question for anyone who may have some information regarding getting OUT of the HPSP after I have signed the dotted line. I a MSI and on an Army HPSP scholarship and all I hear are horror stories about how terrible the residencies are and just in general about military medicine. I was absolutely not completely informed by my recruiter and feel very misled.

    Does anyone know if there is a way out of the scholarship without having to be called to active duty training for repayment? I could be overreacting but I feel like I made a terrible decision and need to know what my options are.
     
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  3. Andrew_Doan

    Andrew_Doan Doc, Author, Entrepreneur
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    I don't think there is a way out. You've signed a contract. Unless you commit a crime, get thrown out of school, or do something that nulls the contract, then you're in. I think the HPSP is a good option. Working as a GMO sucks, but you'll be a doctor in the end. You may be the few that are allowed to go right into residency. I'd just sit tight, work hard, do well, and keep your options open. The military provides a nice career for physicians. If you stay in, then you'll be able to retire from the Army at a young age... and collect the sweet pension.

    BTW, I'm in the NAVY FAP. Different than HPSP, but in the end, it is the same.

    Good luck!
     
  4. CaptainAmerica

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    Before you bail out, I think you should try to get a more representative view of Army medicine. The Army is quickly moving away from the General Medical Officer tours (read: a GMO tour is no longer the expected route before residency). I would also argue that the Army has great teaching hospitals and great residency programs, with opportunities to practice some types of medicine that you would never encounter in civilian practice. Our pass rates on boards are on par with our civilian counterparts, with candidates from some specialties consistently outdoing their civilian peers (the ER program at Fort Hood comes to mind).

    I understand your anxiety, because you are committing several years of life to the military. However, before you bail out of a good program, please take the time to fully research this. The military community is a great place to live and work and offers some outstanding opportunities. Good Luck.
     
  5. Homunculus

    Homunculus SDN Caveman Administrator
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    ouch. who have you talked to and how many horror stories have you heard?

    Most military residencies are great programs-- and as for hospitals just think of Walter Reed, Bethesda, BAMC, Madigan, etc. I don't know who told you the residencies are "terrible", but you need to elaborate a bit so we can maybe dispell some rumors you may have heard.

    The Army is completely eliminating GMO tours, so except for very particular circumstances your chances of getting one are nil. What about military medicine spooks you?

    If you really want out, there are really only a couple of options-- one, get out from a physical disability of some sort (ouch), or two, pay them back and pray. I doubt you can find any legal loopholes with as many documents as they make you sign. If you don't want the scholarship anymore, IMMEDIATELY stop your tuition, monthly stipend and book/equipment reimbursment. The more money you take the more they can hold over your head. Oh, and the money you pay back will have interest attached, so it won't be cheap, but maybe you'll be out of it. Your only saving grace is that you may be bailing out so early that they might let it slide. Try this in your 4th year or after you graduate and you may be stuck serving active duty time as a private, lol.

    anyway, please elaborate if you can about what you're concerned about, people here may be able to help.

    good luck

    homonculus
     
  6. Ludy

    Ludy Senior Member
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    I got out after OBC, which I took BEFORE my first year of medical school. It probably helped significantly that I hadn't accepted any money towards tuition, etc. yet, but they had paid my OBC salary, lodging, and uniform allowance, which I did not have to pay back. I wouldn't worry about the residencies in the Army -- I have also heard that they are excellent. It was the life afterwards that turned me off, and I just decided loss of freedom wasn't worth the cost. Now I have lots and lots of loans, but I also have more control over my life. The military atmosphere also just wasn't for me. Other people have said it before on this board, and it's definitely true: don't do HPSP for the money alone - it isn't worth it. Only do it if you really want to be in the military.

    If you're sure you want to get out, start the process now. I talked to my state rep and had him write a letter, called people in the Virginia and St. Louis offices repeatedly, and just kept bugging them. It still took over a year before I finally got my honorable discharge certificate. It was a major hassle -- and I'd only been in the Army 6 weeks! But the bottom line is that they don't want doctors who hate being in the military, so they'll most likely let you out if you're persistent. Good luck!
     
  7. lambeufl

    lambeufl Junior Member

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    Could someone who went through the process of being discharged from a HPSP scholarship please let me know some specifics about the process before I run off and say the wrong thing to someone in the Army. I have not attended OBC yet, but they have been giving me a monthly stipend for about 3 months and have paid for my tuition.

    I am serious about getting out of this HPSP. The idea of having no debt at the end of medical school would be great, but I think my happiness is more valuable. I am at the point where I have considered dropping out of medical school because I am not excited about my future as an Army Doc.

    Who do I need to contact and how do I initiate the process is some helpful information that I need.

    Thanks.
     
  8. Ludy

    Ludy Senior Member
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    Lambeufl,
    I sent you a PM :)
    Good luck to you!
     
  9. phil413ru

    phil413ru Senior Member
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    lambeufl-

    I would talk to some current Army docs, off duty before you make a decision. I will say, like you have probably already heard, usually the loudest voices are always heard. The discontent voices usually out-voice the content voices. :mad: +pissed+

    Don't listen to horror stories about the military. The residencies are not that bad. Military medicine has red tape, but the same amount of red tape as civilian field. I have worked with military docs. Two wanted out, one loved it. The two who wanted out were both female. :confused: HOWEVER, One had a 2,4,6 year old children. Her husband, a civilian, traveled a lot, so she was often by herself with the children. The other was married, but had been separated from her husband for two years--he civilian finishing med specialty residency, she at Army base. The third doc went to USUHS, and really enjoys Army medicine.

    Before I joined the Army, I always heard horror stories. I read about Vietnam horrors, and was vastly mislead about what the military really was. :eek: Somehow, I felt compelled to join the National Guard. I was still wary of my decision-- I was constantly reminded and told of basic training horror stories. I even saw the movie The General's Daughter the day before I left for basic. I :eek: went --it wasn't that bad. It was actually kind of fun. I joined ROTC. I heard horror stories about Advanced Camp, now National Advanced Leadership Camp (NALC). I went. It wasn't that bad. If it hadn't been for injury, it would have been kind of fun. ;) The key is, usually "horror stories" are like fishing stories. experiences become exaggerated.

    Myself, I have fallen in love with Army Medicine! I actually am going to school outside of Madigan Army Med Center. Madigan treats both civilian and military--the civilians rave about the quality of medicine. I would love to work at Madigan, Tripler (Hawaii), Walter Reed (MD) or Heidelberg (Germany). I am still interviewing at med school, been accepted to one to date, and will be commissioned this Spring at a 2LT in US Army. I will go to OBC and then to either USUHS (pending) or LECOM (accepted). LECOM, I owe 12 years, USUHS I owe 15 (due to undergrad ROTC). I desire to have career in Army Medicine

    The military does have its ups and downs, but so does any civilian organization. In the Army, you only owe eight years. Four of those will be residency. In this residency, you will recieve captains pay (O3). You will get to travel, see the world. You will also get leadership opportunities that you wouldn't get in most civilian residencies. You get to work with soldiers and their families--an honorable opportunity. You will become instilled with a code of honor, leadership, and discpline that extends past your medical training. :) You also get a chance to serve your country.
    Keep in mind that Army has most specialties that the civilian world has.

    I can understand feeling intimadated by the aspect of being in the military--believe me--I was the same. I started Basic Training afraid I made a terrible decision. :( Yet, the Army had a way of growing on me. I heard a lot of horror stories that just were not true. The Army has changed a lot in the past years, and what may have been standard 10 years ago may not be true now. I would at least wait until you have attended OBC, and/or have had the chance to attend a military internship. This will give you an excellent opportunity to see what Army is really like--firsthand. Please don't let secondary horror stories convince you that you made a wrong decision. By the time you finish your residency and four years, it really isn't that long. At that time, you can decide whether or not to continue in military. Plus, if you left then, you have an honorable discharge with a stellar record of not just patient care, but also noteworthy leadership experience and character from being an officer in the United States Army.


    Good Luck!
     
  10. JANCHEL

    JANCHEL Junior Member

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    Just a quick addition to the above post. Yes you will owe the army 8 years (for a 4 year HPSP scholarship), but residency does not count towards that. It will be 4 years on active after residency, and 4 years on reserve.
     
  11. edmadison

    edmadison 1K Member
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    I thought the reserve time was three years. In any event, the reserve time can be served as IRR which means you don't have to drill or serve during the summer. Of course you can get called up.

    Ed
     
  12. drtedjefferson

    drtedjefferson Junior Member
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    I am a resident in a civilian residency interested in the Army. Anyone out there know what the "real" salary is as an O-3 working inthe military as a doctor???? the pay charts give you a complicated formula of 5 different pays that add up to around 95,000 per year. BUT , the fine print says that one of the salarys (I think its called "special Medical pay???") which is listed at 36,000 can be taken away from you and the fine print says it is "UP TO 36,000".
    "Up to 36k" is alot different than "36k." Anyone who really knows what they are talking about from experience (not just reading) can they tell me what is the bottom line. How much do you make. Thanks.
     
  13. Andrew_Doan

    Andrew_Doan Doc, Author, Entrepreneur
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    The 36K special pay depends on your speciality. 36K is the highest allowable, and I think ortho gets this pay. As an ophthalmologist, I get around 28K.
     
  14. BenHoganFan

    BenHoganFan Member
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    Here is the actual pay chart related to your specialty. Keep in mind that the scales change based on the staffing of the specialists in the military. The amount is based on Navy pay but the army and air force should be similar.
     
  15. BenHoganFan

    BenHoganFan Member
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    I am just curious. WHY did you even consider applying for a HPSP program and WHY did you sign the contract if you don't want to follow through with things.

    You even took an oath:

    Army Officer Appointment Acceptance and Oath of Office

    I lambeufl, having been appointed a 2nd LT in the U.S. Army under the conditions indicated in this document, do accept such appointment and do solemnly swear (or affirm) that I will support and defend the Constitution of the United States against all enemies, foreign and domestic, that I will bear true faith and allegiance to the same; that I take this obligation freely, without ANY MENTAL RESERVATION or PURPOSE OF EVASION; and that I will well and FAITHFULLY discharge the duties of the office on which I am about to enter, so help me God.


    Keep in mind that the NRMP Match is a contract also regarding accepting a residency position. READ THE FINE PRINT and make sure you rank where you want to end up. That is, if Uncle Sam is willing to let you get out of the military. With the way the War on Terror is going, you BETTER HOPE that the ARMY doesn't declare a STOP LOSS like the United States Marine Corps did recently and what the US Navy did right after 9-11.


    Don't forget that we take another Oath when we graduate from Medical School:

    The Oath

    By Hippocrates

    Written 400 B.C.E

    Translated by Francis Adams

    I SWEAR by Apollo the physician, and Aesculapius, and Health, and All-heal, and all the gods and goddesses, that, according to my ability and judgment, I will keep this Oath and this stipulation- to reckon him who taught me this Art equally dear to me as my parents, to share my substance with him, and relieve his necessities if required; to look upon his offspring in the same footing as my own brothers, and to teach them this art, if they shall wish to learn it, without fee or stipulation; and that by precept, lecture, and every other mode of instruction, I will impart a knowledge of the Art to my own sons, and those of my teachers, and to disciples bound by a stipulation and oath according to the law of medicine, but to none others. I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit of my patients, and abstain from whatever is deleterious and mischievous. I will give no deadly medicine to any one if asked, nor suggest any such counsel; and in like manner I will not give to a woman a pessary to produce abortion. With purity and with holiness I will pass my life and practice my Art. I will not cut persons laboring under the stone, but will leave this to be done by men who are practitioners of this work. Into whatever houses I enter, I will go into them for the benefit of the sick, and will abstain from every voluntary act of mischief and corruption; and, further from the seduction of females or males, of freemen and slaves. Whatever, in connection with my professional practice or not, in connection with it, I see or hear, in the life of men, which ought not to be spoken of abroad, I will not divulge, as reckoning that all such should be kept secret. While I continue to keep this Oath unviolated, may it be granted to me to enjoy life and the practice of the art, respected by all men, in all times! But should I trespass and violate this Oath, may the reverse be my lot!
     
  16. Kirk

    Kirk Senior Member
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    He probably wants out because he didn?t realize what he was getting himself into. I know I spent 6 years in the military, and I sure didn?t know what I was getting into (although I thought I did). Yes, he probably swore that oath, but so do a lot of other people that get out of the military.

    Also, you can take the oath of Hippocrates when you graduate from medical school, but I am not going to pretend to swear to something as ridiculous as that. It is outdated, sexist, and goes against my personal beliefs.


     
  17. BenHoganFan

    BenHoganFan Member
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    Kirk,

    You're right the Oath of Hippocrates is outdated but it was more for dramatic effect.

    I was referring to the Army Officer Acceptance Oath.

    Anyways, lambeufl, it's better to try to get out now before the government pays more money for your education. Worst case is paying for your one years worth of tuition, books, etc plus interest versus waiting until you're a fourth year medical student. Hire yourself a lawyer.
     
  18. gtb

    gtb Member
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    1.) You are not in the Army.
    2.) You are not in the Army.
    3.) You are not in the Army.

    Until you actually go active duty, you are not in the Army. Don't let anybody tell you anything else because they are mistaken.

    Certainly the Army (and I as taxpayer) expect you to pay back any funds, with intrest, that you have received. But there will be no penalties, no unfair charges associated with the payback. It's probably unnecessary but if you feel better, get a lawyer to help you complete all the paperwork to terminate your association with the Army.

    An important point to keep in mind is that the military does not want individuals who feel strong-armed into joining. If you are uncomfortable speaking with the recruiters mananging your education, keep moving up the chain of command until you find somebody more willing to work with you. Just remember, you are not in the Army.

    Good luck getting this resolved.
     
  19. edmadison

    edmadison 1K Member
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    You are in the army if they want you in! There is a reason that they swear you in right after you sign the contract. It's so they own you! Once that is done, you are subject to their rules and regulations and courts. If you are going to get a lawyer, make sure that you get one experienced in these matters or you will pay a fortune in legal fees as he/she gets up to speed. From what I understand, they won't let you off the hook unless you are such a pain in the ass that it's more trouble than its worth for them to keep you.

    Good luck.

    Ed
     
  20. MeganRose

    MeganRose Senior Member
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    To the OP,
    It might not be necesary to get a lawyer, esp since you're getting out relatively early in the game. My experience with DOD scholarship contracts comes from making a switch from Navy ROTC to Army ROTC during undergrad. In the contract I signed with NROTC, it specifically stated that in the event that I decided to violate the contract, I had two options: Serve time as an enlisted member or pay back the tuition paid, plus minor financing charges and interest to DFAS. (I ended up not having to do either as my comissioning as a 2LT in the Army fufilled the terms of the original contract) I'm sure that in your case repayment will undoubtedly be an option.

    It seems that the bottomline is that they would like you to fufill the terms that you agreed to in your oath but fundamentally don't want a servicemember that doesn't want to be there and probably wouldn't make a good officer bc the military isn't where they want to be. Ignore what that other poster said about you breaking your oath. Its not an unforgivable sin-- the military is not for everyone. But get the ball rolling right now so you don't get yourself any deeper.
    Good luck,
    M
     
  21. TulaneKid24

    TulaneKid24 Senior Member
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    How about telling them that you are gay/homo?? That way, they kick you out!
     
  22. mitchconnie

    mitchconnie Member
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    I think lambeufl sounds incredibly well-informed--i.e. has talked to someone other than recruiters. People like Opthomdphud who rave about how great the military is have not been on active duty as a doc. yet.

    I am, and belive me, morale is in the toilet among the clinicians who are interested in delivering quality health care. Picture yourself at a hospital with all the bureaucracy of the VA, but without any of the interesting cases.

    The pay is really not bad, particularly when you consider the hours that you work. Trouble is, for a surgeon like myself, there is little work to do beyond hernias and breast biopsies. I cannot maintain my skills and will be unemployable when I leave the military. This does not even take into account my yearly trips to the desert where I get to live in a tent for three months and take care of colds and athlete's foot.

    My impression of military GME programs (like the place I trained) is that most will struggle to stay alive let alone stay high-quality. Tri-care has decimated the patient base and the leadership has zero interest in GME. The internal medicine program at my institution had to close up shop and combine with the civilian program nearby. I can name several military programs, some at big name places, which have been forced by the RRC to cut back on the number of people that they train or close altogether.

    My advice to any medical students in HPSP is to get out while you can. HPSP may be a great option if you are at a high-priced school and want to go into primary care, but for most people this is not the case.

    My understanding is that you can get out as long as you are not yet on active duty. When I went to HPOIC, about 10% of the class actually left the military once they found out what was really going on. Their recruiters had misinformed them.
     
  23. Andrew_Doan

    Andrew_Doan Doc, Author, Entrepreneur
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    True. I haven't been on active duty; however, this does not mean I am clueless. I speak with informed knowledge. My experiences are with military ophthalmologists, and most have loved their careers. In fact, most are serving 20+ years. If military medicine is so horrible as you seem to claim, then why are these men and women serving more than their required service time? Many of my good friends are also in military medicine. Although I haven't served as an active duty physician, I do know what I am talking about.

    Clearly military medicine is not for everyone. But if you enjoy the the military and work hard, then this can be a wonderful career choice.
     
  24. Andrew_Doan

    Andrew_Doan Doc, Author, Entrepreneur
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    This sounds like most private practice physicians. Unless you're in an academic institution, private practice cases are relatively routine as well.

    BTW, I received an email from an ophthalmologist assigned to the naval hospital in Great Lakes, and he's surprised with the pathology that walks through his clinic. He states that there was no need to study for his ophthalmology boards because by working with the Navy he saw everything. This same physician is now doing a retina fellowship at a civilian hospital. He's been very happy and find his military practice challenging.
     
  25. mitchconnie

    mitchconnie Member
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    I would certainly not claim that military medicine is terrible across the board. I think there are certain docs for whom it makes a lot of sense, but they are NOT in the majority.

    For whatever reason, the optho guys seem satisfied--perhaps because they are not deployable and still see some interesting pathology. Peds seems to be reasonable, since the pay is actually better than the civilian side, and there are certainly a lot of military families with kids. Again--they are not deployable.

    It is also a good place for people who are interested in administration rather than clinical care, and single people who are interested in traveling, but don't care to have a busy practice.

    Trouble is, recruiters sell it as something that is great for most everyone, and people like lambeaufl get sucked in because they are scared of incurring massive debt. Here are some recruiting half-truths that a lot of people fall for.

    You'll get to travel and "see the world."--The bases you want to go to(Germany, England, Calfornia, Florida) are in high demand and you often need to do a hardship tour (Middle East, Korea, Turkey) to qualify for reassignment. Or sign up for additional committment. As a resident just coming out, you get last pick (North Dakota, West Texas, etc.)

    You avoid paper work hassles and "focus on taking care of patients"--The hassles are every bit as bad as any HMO and you have little office staff to help you.

    No Malpractice--Patients do bring suit against the government, who then come after you. The inquisition is every bit as bad as a civilian deposition. I have seen it happen to good docs, often over very minor incidents.

    You can do whatever specialty you want--Quite true, as long as you want to do something they need. Good luck with getting that urology residency.

    You can do whatever residency you want, civilian or military--If the military doesn't fill their slots, you have to do the military program. People often do get what they want, but what if you don't?

    The Military training is top-notch--no one can deny the reality that many military GME programs are in trouble, scaling back or closing. Good places still exist, but it is highly unlikely that you will end up somewhere that is as good as a civilian University program.

    Residency counts for payback--Just an outright lie. I can only conclude that some recruiters are misinformed.

    You'll have a busy practice with referrals from all over the world--I worked at a so-called Major Medical center and did 50 operative cases last year, 40 of them were hernias and breast biopsies. this is a pathetic general surgery practice by ANY standard--rural or urban, academic or private.

    We have all the latest technology--Our ortho equipment is a decade behind, and the same with our laparoscopy equipment. Our "laser eye center" is great, but only because is directly supports the flight line.

    Most people, including myself, went in completely blind to the reality. Many are shocked at what they find in the post-Tri-care medical corp. Some people are happy all-around, most dislike their practice but enjoy the free time, and others are profoundly bitter. I'm in the middle category.

    I sympathize with lambeufl and wish him/her all the best. Hope I never have to see him/her out here in the trenches.
     
  26. Caffeinated

    Caffeinated Army Strong
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    I think someone may have already said it, but I will say it again for emphasis. Yes, you are in the Army. Students are commissioned before they receive a dime, and assigned to the control group, USAR PERSCOM, St. Louis. This may not be what you want to hear, but all med students on Army HPSP are commissioned as 2LT in the Army Reserve. That constitutes "in the Army." I don't doubt that a few people have broken free before being called to AD. However, this is the exception, not the rule. Some have hired lawyers and failed.

    I am truly sorry for all those who were lied to and misled by recruiters. If I could change this system, I would in an instant. But by the same token, I also want to emphasize that although military life is not a 24-7 party, it's not 24-7 misery either. As with anywhere you go, you will find people at all extremes: those who hate it with a passion, and those who love it, and those who see the realities and deal with them to suit their situation. Military medicine is not utopia, but neither is civilian medicine. My one wish for all that read this is that you aspire to reach your full potential as a physician, either as a civilian or military doc. But I think it is possible to do this in either route. You must decide what route suits you best.

     

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