Hello, I'm starting med school in August and am thinking about taking the Army HPSP (If I get it of course). I desperately want an orthopedic surgery or anesthesiology residency and was wondering what the chances of scoring one of those might be, or even getting a civilian deferment to pursue the above? Also, what might one need to do to get one of the above?
Army HPSP who wants Ortho or Anes
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Let's start with: Not Good. They are competitive.
How do you score one? Good Grades, Good Board Scores, Good abilities, research doesn't hurt.
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Just today an appropriate quote from another thread:
Originally Posted by ActiveDutyMD
What is it that excites you about being a military doctor? Forget about getting the scholarship, or getting the match. You need to first determine if your idea of what a military doctor does on a daily basis is accurate. If the "commitment to the military has no bearing on you" that I have to say I suspect you don't actually understand what that means.
It means the military determines where you live. The military determines how much time you spend away from your family. The military determines where and when you train in your chosen specialty. It determines what your practice will be. You may want a practice that is predominantly trauma surgery for instance, but end up doing mostly diagnostic colonoscopies with an occasional appy thrown in for kicks. It determines how much admin work you will do instead of clinical medicine. It determines how and when you will work out. It determines what days you will come in early for commander's calls and which of your days off you'll lose just to come in and sign an OPR that suddenly became an emergency.
It is a noble thing to serve in our nation's military, because the sacrifice is GREAT. If you are not prepared to sacrifice time, pay, effort, your family, and your medical skills, be very wary about joining the military as a physician.
Cannot emphasize enough, if you do not want the chance of having your training interupted, or having to do your training in a place you really rather would not, or having to work at a place where your skills are not being used, then AVOID military medicine. Read this forum throroughly, and ask as many questions as you need to understand what you are getting yourself into.
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So far you've received an opinon from the Navy and the USAF. I'm Army. Life is competative. If you are a good applicant, have an excellent work ethic, good interpersonal skills, good clinical skills and intelligence you are competative. I do not think you have much chance of getting a deferment. Good luck if you choose to join. All I can tell you is the process is fair, and the best generally are rewarded (my experience).
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Do you think he has much of a chance of straight through training? The last data I saw showed a 25% GMO rate for Army. Since most folks in primary care seem to go straight through, that tells me that the odds of straight through training for anesthesia probably isn't great and I'd be very curious about the odds of straight through ortho.
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It's so cute how you guys stroke each other's egos . . . .
To the OP, I'll give you my perspective, someone in your shoes who is going HPSP this Fall (Navy), albeit I'm not the typical pre-med (I'm a little older, 30, have wife and baby, have almost 10 years experience in the Navy, first as a surface warfare officer, then as an engineer):
To be honest, everything ActiveDutyMD said in his quote above is true . . .you will be away from family at times, your career path may be determined for you etc etc.
I'll add the caveat that in the military, you can do a lot of things to steer your own career too. But the key to being happy is flexibility. If you want to do Othro or Anes, and if you're a good student w/ good stats, that is attainable . . .you may not get the timeline you want (training straight through), but that's where you flexibility has to kick in. If you don't have such flexibility and you really have to go straight through in the specialty of your choice (or it'll kill you), then hpsp is probably not the right deal for you. you can still serve through the FAP program (where you come in after training) or through the Reserves.
Now, everything being said, you do have to have a desire to be in the military . . .to serve . . .to be a part of higher calling, etc etc. If you have no such desire, then don't join. Agree with ActiveDutyMD that it's a great sacrifice (oh and btw it's a sacrifice that many, not just docs, in the military have to make), but it can also be a very rewarding and cherishable experience.
Just FYI, there have never been any official Army GMO % rate released, so you should stop quoting this 25% rate. I think you are referring to match statistics from last year that I did some funky math on out of curiosity but which by no means is accurate.
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This is from someone else that posted the published match statistics. If the Army wants to release the actual GMO % rate, they're welcome to. Until they do, folks will calculate it from published Army match statistics.
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To answer Dr Roast's question....
Based on 2008 Army match statistics:
Anesthesia: 15 applicants applied for 12 spots. So looks like an 80% match rate
Ortho: 35 applicants applied for 19 spots. 54% match rate.
Anesthesia looks to be better odds than I thought. It certainly looks better than Navy. But at the end of the day, unless these anesthesiologists applied to multiple specialties and snagged a second choice specialty (worse than a GMO, in my opinion), it means 1 in 5 did a GMO tour.
For ortho, almost half of applicants apparently went GMO. Maybe half just weren't competitive (as per a1qwerty55), but really it probably means it's just a very competitive specialty in the military and you should expect a strong chance of a GMO tour.
Based on 2008 Army match statistics:
Anesthesia: 15 applicants applied for 12 spots. So looks like an 80% match rate
Ortho: 35 applicants applied for 19 spots. 54% match rate.
Anesthesia looks to be better odds than I thought. It certainly looks better than Navy. But at the end of the day, unless these anesthesiologists applied to multiple specialties and snagged a second choice specialty (worse than a GMO, in my opinion), it means 1 in 5 did a GMO tour.
For ortho, almost half of applicants apparently went GMO. Maybe half just weren't competitive (as per a1qwerty55), but really it probably means it's just a very competitive specialty in the military and you should expect a strong chance of a GMO tour.
Yeah, I know which numbers you're referring to, which including some dubious math (http://forums.studentdoctor.net/showpost.php?p=6712547&postcount=32). I'd point out the flaws in his assumptions but what's the point? You'll quote what you want to quote.
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To be honest, I don't much care about the overall match rate. I don't think anyone should. No one applies to an overall specialty. What matters is your specialty'smatch rate.
The 80% for anesthesia and 54% for ortho seem pretty solid. The Army publishes the number of applicants and the number of slots awarded. I don't exactly know how it can be misinterpreted, but if you see something dubious, feel free to point it out.
And I'm not slamming Army. It's a lot better than Navy numbers I've seen.
The match rates are a lot lower than in civilian sector, but here's something to keep in mind: if you don't match in the military, your odds go up after a two year GMO tour. I have a hunch that those who don't have much success in the match in the civilian sector don't improve their chances as much the next go 'round.
Now, now, don't be a martyr... What's the point?
I quote the numbers available. I'd love to quote something more positive (like the number of returning GMO's who match), but if the military doesn't want to supply it, so be it.
Wow, that actually doesn't seem that bad. Ortho still looks pretty tough though. Can you tell me where you found those #'s and where I could find similar numbers for civilian match, both osteo and allo? If not thats cool, but I notice in a post below you stated these stats were lower than that of the civilian sector so I'd just like to do some comparing.
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WARNING: Number of applicants to a particular specialty can, and most likely will, change every year, as will the number of spots available.
Yet you still continue to quote overall match rates.
Agreed. These specific numbers are not dubious. I was contending your overall match rate, not specialty-specific match rate.
As you said, overall match rate is pointless. Specialty-specific match rate is more relevant. As for my martyrdom, I was referring to previous threads (http://forums.studentdoctor.net/showthread.php?t=367738 and http://forums.studentdoctor.net/showthread.php?p=6591067) where we have gone through this before. I was the one who calculated about 50-60 applicants per year not getting their specialty of choice while you and someone else erroneously made incorrect assumptions and calculated incorrect match rates. Bottom line is if you want to calculate correct match rates from the published numbers, the Army match rate into first choice of specialty is closer to 80-83% (about 50-60 unmatched into specialty of choice out of 300-310 applicants). But as you said, overall match rate is meaningless because it's really specialty dependent. I hope that settles things a bit.
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If you're comparing it to the civilian match, it's pretty rough. But if you're committed to joining and are looking for a service, it's not bad at all. For Navy, the mentality seems to be to expect a GMO tour for many specialties outside of primary care.
For Army, don't believe the "no GMO tour" hype recruiters and some posters will toss out there. But it's a much better situation than some of the other services.
Here's the link for the Army, showing the number of applicants to number of positions. <edit: results posted here on SDN. You can also use ieatpizza's link above to see source material from the PPT>
Here's the link for NRMP. It links to their Data and Reporting page. There are docs showing match %'s as well as a great doc called "Charting Outcomes for the Match" that shows research background, Step I scores and other information about the different specialties.
I know nothing about osteo. Sorry.
No sweat. Check out the resultsanddata2008.pdf. If you dig, you'll find what you're looking for.
Orthopedics had an 83.6% match rate. Anesthesia had a 94.4%
Yep, if you look at the PPT that I linked to (Slide 5-Residencies), all Army residencies are continuous contract except for Gen Surg, Rad Onc, Preventive/Occupational, and Aerospace.
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So if most all specialties are continuous tract (applicants don't reapply for PGY-2) but tracts like ortho have 1.84 applicants per slot, what happens for almost half the applicants who do not match into ortho? What happens to those on the GMO tours?
Straight through training for all these specialties sounds great for those who match. But for those who don't, it sounds as if they'd be better off Navy where they will get preferential placement for their PGY-2 year over fresh blood.
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Tired can probably provide a more accurate answer, but my impression is that some PGY-2 spots are reserved or become available to GMOs and interns who didn't match into PGY-1 for competitive specialties like ortho. Continuous contract just means that if you matched out of med school you don't have to worry about reapplying for PGY-2.
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Okay.
So the takeaway is that for ortho, you have a 54% chance of getting straight through training. If you're in the half that doesn't get it, prepare to do a GMO tour. When you finish that two year tour, there will be as many as 16 folks with the same GMO experience applying for an unknown number of slots that might be held for you to fight for.
By my read, for ortho, your odds are better applying for it the first time in the Army and the second time in the Navy.
To play the system, go Army HPSP and apply to Army ortho out of med school. If unsuccessful, complete intern year and transfer to the Navy for GMO tour and apply for PGY-2 ortho through the Navy.
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Sounds like a plan.To play the system, go Army HPSP and apply to Army ortho out of med school. If unsuccessful, complete intern year and transfer to the Navy for GMO tour and apply for PGY-2 ortho through the Navy.
Thank god I have no love lost for ortho...
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Yeah, I can't imagine you'd make it that far and then choke that badly out of the gate.
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This is exactly right for Ortho at this point in time in the Army - remember the numbers can vary year to year, but I get the impression that Ortho is going to be pretty flush with applicants for the forseeable future. The funny thing is, as a med student, I met quite a few prior Ortho residents in other residencies who said they quit because it wasn't what they were expecting. So maybe not too long ago, a GMO had a decent shot at getting a slot...Wouldn't count on it these days.
From what I can see, it seems to be getting that way for all of the GS and Surgical Subspecialties...except Ophtho, who have had several people quit recently
. For anesthesia, if I understand correctly, some of the programs actually save a slot or two just for GMOs in their R2 class.Another rumor that someone may be able to confirm or deny...I've heard that GS is going to get away from the re-application process for the R2 position. The way GS currently works is that there are more R1 residents than there are R2 slots (some programs have as many as double the number of R1s as there are slots for R2s) - effectively making all GS R1s prelims. The R1s must all compete and re-apply for R2 and from then on it's a continuous contract. The unfortunate who don't get picked up can try to get into one of the other MTFs if there are slots or it's GMO land. I wonder if the Army can continue this practice with the dwindling number of HPSP grads and the fact that a GS residency doesn't do a whole lot to prepare you for GMO....To tie this question back in with this thread, I guess this would mean that the match rates for GS are skewed high as well, with the number of R1 slots not really correlating with the number who are actually able to complete a GS residency.
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This year, at least, there were about 12 applicants for 7 urology slots.
Explain to me what orthopedic surgery and anesthesiology have in common to allow you to single those two out and reject the others before you have any medical training? Those are two extraordinarily different fields.
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My first thought as well, not casting stones though. I was a military ortho applicant in the Navy, didn't really enjoy the view I got of it in my intern year, and am grateful for my FS tour. AND, I'll be heading to a civilian anesthesia residency when I finish my obligation.
Two very different fields, but ortho's perceived difficulty to get into (civilian and military) make it attractive to some of us Type-A medical people. After all, if it's hard it must be better, right?
At least I got over that in the military. Anesthesia offers a pretty sweet deal, the opportunity to scale your practice to your own desires to a degree that is hard to find elsewhere. Maybe the OP has worked with some medical types? Anesthiologists and Ortho surgeons have (WARNING: sweeping generalization follows )been my favorite attendings/residents in terms of being fun/pleasant to be around. Just a thought
Wow, easy with the hostility. They are alike in that both take place in a surgical setting, different in that one has a more clinical side. But in both you are doing hands on things in the OR which I like. They are less alike than Urological Surgery and Bariatric Surgery, but more alike than Psychiatry and Gen Surgery. I don't reject all others. I have a large amount of clinical experience in everything from Family Med to Neurosurgery, and I felt like the two in question were the ones I enjoyed the most. Absolutely not saying I won't change my mind, but right now I want them. I don't understand why you posted what you did, would you like to contribute to the thread?
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I disagree, I don't understand why that person wrote what they did, it did not contribute to the question I posted. Nor do I understand why you posted what you did for which I am replying. I think both of you are trying to take a stab at me. Those specialties are just the two I'm interested in now, money obviously has nothing to do with it b/c if I remember right this is a military medicine forum, and all physicians are paid roughly the same in the military depending on rank and years in (+/- a bit for specialty pay) so again I don't know what both of you are trying to achieve by posting that. Your first post was helpful though, thanks for that.
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I've been hearing alot about transitional year residency/internships for people who dont match in the more competitive stuff in the Army match. Ie, ortho, anesthesiology, EM, etc. You would do a transitional year and attempt to match into the second year of the program you wanted next year. Does anyone know anything about this?
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i can tell you this, a transitional year won't get you into ortho, at least not without some time on your knees "begging" and redoing most of your intern year.
I recently visited BAMC and the ortho program director told us that if you don't match at first, you can do the Trans year, and reapply. In that time you can try and beef up your application to apply again, but you can't change your grades/scores so I don't know how much good it would do. But, he did make it sound like it was a possiblity and has been done often. He might have just been blowing smoke at me to try and get me to join the military. Who knows.
My first thought as well, not casting stones though. I was a military ortho applicant in the Navy, didn't really enjoy the view I got of it in my intern year, and am grateful for my FS tour. AND, I'll be heading to a civilian anesthesia residency when I finish my obligation.
Two very different fields, but ortho's perceived difficulty to get into (civilian and military) make it attractive to some of us Type-A medical people. After all, if it's hard it must be better, right?
Maybe the OP has worked with some medical types? Anesthiologists and Ortho surgeons have (WARNING: sweeping generalization follows )been my favorite attendings/residents in terms of being fun/pleasant to be around. Just a thought
So, am I understanding this right. Your finishing your obligation as a GMO and heading to civilian for anesthesia when your finished? I've always heard waiting to do residency after your obligatory time was difficult and a bad idea. Are you saying its not and is doable? b/c that would be super!
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You provide a fairly reasonable translation of my statement.
It is needs of the Army/Navy/USAF, so it's possible, but there are plenty of qualified applicants each year, as is well documented by the fairly consistent applicant/spot ratio approaching 2.
It is needs of the Army/Navy/USAF, so it's possible, but there are plenty of qualified applicants each year, as is well documented by the fairly consistent applicant/spot ratio approaching 2.
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I've had great feedback from my interviewers regarding my service, and I interviewed at top tier programs. As I understand it, the post-9/11 GI Bill will pay me the E-5 BAH (housing allowance) for 36 months of residency. Since I will most likely end up in SoCal for residency (I'll know in 2 months), that will mean upwards of $2100/month extra income.
There will certainly be some culture shock on returning to the civilian world and the 80-hour work week in residency, but I can do that.
That's why it was odd. Normally, it would just be a premed looking at the job board and salivating, which would make sense. But those two choices didn't really make sense given that the biggest thing they have in common is their position at the top of the payscale in the civilian world. I am assuming that you intend on a military career. If you're looking to get in and get out, then your counterargument isn't valid and it really makes it seem like you're cherry-picking again.
Guess I struck a nerve, huh? Sorry. To answer your question, the Army seems to usually have a high need for surgeons. The question was answered in the thread already. There are more ortho spots than anes spots (although a little more competition for ortho). The point here, is that it isn't something worth making a decision to enter the Army on. If the spot means that much to you, then you will do the work, get the scores, and get the slot. If not, you'll end up elsewhere. No worries. The same pressures exist in the civilian match.
Fair Enough
The easy answer to all of your questions, from someone who is currently STUCK in Navy GME land is this: DO NOT SIGN UP FOR ANY OF THE MILITARY PROGRAMS!
I would rather have $500k in debt right now then have had a "free ride" in med school and be making about $10k more per year now then my civilian resident friends. In the long run civilian pay more then makes up for that.
Regardless of what field you want to go into think of this: In the real world (civilian) you work hard, do well, score well on your exams and generally will get accepted for what you want to do, where you want to do it. You have control over your career and your field of choice. In the NAVY if you work hard, do well on all of those things you still may get picked for your field of choice but then get sent out to spin your wheels for 3-4 years before being able to come back or get out of the Navy because you realized what a waste of time it is ... then you're 5 years out of med school and in the same place you were.
bottom line: if you want ANY say in how your career gets started and plays out in the early years: DO NOT JOIN HPSP. I wish someone had laid it out like this 5 years ago before I signed the bottom line. I wish I had the debt but my pride and freedom. now i'm stuck, but you don't have to make the same mistake. DON'T SIGN UP FOR HPSP!
I would rather have $500k in debt right now then have had a "free ride" in med school and be making about $10k more per year now then my civilian resident friends. In the long run civilian pay more then makes up for that.
Regardless of what field you want to go into think of this: In the real world (civilian) you work hard, do well, score well on your exams and generally will get accepted for what you want to do, where you want to do it. You have control over your career and your field of choice. In the NAVY if you work hard, do well on all of those things you still may get picked for your field of choice but then get sent out to spin your wheels for 3-4 years before being able to come back or get out of the Navy because you realized what a waste of time it is ... then you're 5 years out of med school and in the same place you were.
bottom line: if you want ANY say in how your career gets started and plays out in the early years: DO NOT JOIN HPSP. I wish someone had laid it out like this 5 years ago before I signed the bottom line. I wish I had the debt but my pride and freedom. now i'm stuck, but you don't have to make the same mistake. DON'T SIGN UP FOR HPSP!
I'm confused, are you currently a GMO in the Navy or are you in a program? B/c I don't know how you could be so bitter if you got the residency you wanted. Perhaps your med school had low tuition and the financial benefits of HPSP were a wash for you. The med school I will be attending is almost 50K/year so it's seems to have some financial benefits for me at least. Please enlighten me a little I'm interested to hear more of your story, this is good stuff.
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Roast,
the bottom line, is that you have to look at the numbers and predict some things about your future.
If you want to do a low paying specialty, and tuition is high, then you may come out ahead financially.
If you think that you can predict so much about who your going to be in 4-8 years then you need some more life experience.
As Crazybrancato has said, an enormous amount of flexibility is required to make the .mil work for you.
Your plans are likely to change, but once you have signed that contract, the .mil of your choice owns you. If you decide to change specialty, you may be able to make it happen, but it will be on their terms not yours.
There were many times during my GMO that I would have gladly taken debt over time.
At the end of my first GMO I could have gotten into the residency I wanted in the Navy, but my concern about its quality and complete terror at adding time to payback was enough to convince me to finish my time in a second GMO tour and get out.
good luck, and make sure you keep your account active and post back when your a GMO, or hating the residency of your choice.
i want out(of IRR)
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I would just like to echo this sentiment. This year alone, in my office, 3 flight surgeons are finishing their GMO tours and separating from the military, so they can go into civilian residencies and be free of any additional commitment. One will go into the Guard, another into IRR, and the third undecided. I will be doing the same next year.
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Different number of FS's at my clinic, but same story, 2 out last summer, me next year. There are 2 other guys going back to military residency, but both have additional commitment from USUHS/NROTC. One of them just signed his paperwork extending his commitment to July 2018, he freaked out a little at that, and he wants to retire from the Navy
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Have you been offered any out-of-match slots? I took one at Pitt and two of my friends took slots at Hopkins and Iowa. If not, good luck in the match. I am sure you will do very well. Did you already do your match list, if so?
