Army HSPS

[djones473]

Does ANYONE like this program? Or is nothing but bad news?

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[TheGoose]

i think youre probably referring to HPSP. and if this is the case, everyone will direct you to reading the stickies in the forum and doing lots of research. =D

 

[BomberDoc]

The HSPS is great. Pay is awesome, morale high, paperwork low, retention near 100%.

The HPSP is the devil's work.

Guess which one is offered by the military...

 

[djones473]

yes I mean HPSP. come on- someone has to have liked it.

 

[BomberDoc]

yes I mean HPSP. come on- someone has to have liked it.

Spend some time reading these forums. Get a feel for the tone of the particular authors of certain posts. There are people here who will tell you that the military is the best thing since sliced bread. These people are also generally regarded as idiots and self-serving cheerleaders who want to put on stars. There are the level-headed few who will really tell it like it is. Then there are the malcontents like myself who are totally pissed at the system and the idiots who run it. After several hours/days of reading, PM some folks and cold call military clinics and ask to talk to the docs. Gather as much info as possible. If you still think it is a good deal, go right ahead and sign on the dotted line.

 

[djones473]

Why do you care?

Take a guess. I think you can figure that one out if you put your mind to it.

I have been reading around older threads but it seems like its the same few people who write the negative posts. I'm going to get in touch with some military doctors to hear their sides. I was just wondering if anyone posting in this forum has had a good experience.

 

[wanabdoc]

The idea of financial benefits from the HPSP has been beaten to death here, BUT, from a financial perspective, in the future since doctor's salaries are going to inevitably fall, wouldn't it make financial sense to join the military from a private school (if I graduate, I will have 250k in debt, and I want to do primary care, which would take 30k per year to pay back my loans over 10 years, or I could join the military, pay off my loans in four years while still earning about the same, with more residency money.

 

[djones473]

The money thing is great, but I feel like there are many other good reasons to do military medicine. I'm worried they are just false hopes though.

 

[TheGoose]

read this: http://forums.studentdoctor.net/showthread.php?t=256225

 

[NavyFP]

yes I mean HPSP. come on- someone has to have liked it.

There are many out there who like the program. Most do not post on this site. You decision will come down to this: Do I want to be in the military? Joining HPSP means you are joining the military with all its good and bad. You will be giving up a certain level of freedom to choose, but it is not the military's goal to make your life miserable. With the exception of primary care, pay will be lower in the military, but you have the opportunity to serve some of the best people our country has to offer. I don't think anyone here will dispute that we have a great patient population.

If you are flexible and have a strong desire to serve, HPSP is a good route. If you want what you want when you want it.......No. Stay away.

 

[Perrotfish]

yes I mean HPSP. come on- someone has to have liked it.

The biggest complaint on here, not related to military life in general, seems to be that the military may keep you from getting your residency of choice. Make sue you understand the GMO and military match system before you apply.

 

[73BARMYPgsp]

Spend some time reading these forums. Get a feel for the tone of the particular authors of certain posts. There are people here who will tell you that the military is the best thing since sliced bread. These people are also generally regarded as idiots and self-serving cheerleaders who want to put on stars. There are the level-headed few who will really tell it like it is. Then there are the malcontents like myself who are totally pissed at the system and the idiots who run it. After several hours/days of reading, PM some folks and cold call military clinics and ask to talk to the docs. Gather as much info as possible. If you still think it is a good deal, go right ahead and sign on the dotted line.

Gosh, I sure hope the people on this site don't think of me as an idiot and self-serving cheerleader. That would really hurt my feelings.

 

[BomberDoc]

I'm not calling you out, 73B, even though you are particularly positive. Nobody really knows what to do with the shrinks anyway. People either fear them or just leave them alone because we aren't comfortable with shrinking. Plus, we know it is impossible to hurt the feelings of a Mental Health type. I still remember my inpatient Psych rotations at the VA with all the hardcore crazies. You guys are seriously up-armored mentally and I doubt I could put a scratch on the paint. Although those of us outside your office continue to figure that the longer you work with crazies, the goofier you become. Just thought I ought to share that little tidbit with you.

For everyone else: military medicine still sucks. Join at your peril.

 

[73BARMYPgsp]

I'm not calling you out, 73B, even though you are particularly positive. Nobody really knows what to do with the shrinks anyway. People either fear them or just leave them alone because we aren't comfortable with shrinking. Plus, we know it is impossible to hurt the feelings of a Mental Health type. I still remember my inpatient Psych rotations at the VA with all the hardcore crazies. You guys are seriously up-armored mentally and I doubt I could put a scratch on the paint. Although those of us outside your office continue to figure that the longer you work with crazies, the goofier you become. Just thought I ought to share that little tidbit with you.

For everyone else: military medicine still sucks. Join at your peril.

As strange as it may seem, we would probably make pretty good friends, Bomber. You made me laugh, which I needed right now. Thanks.

 

[Galo]

There are many out there who like the program. Most do not post on this site. You decision will come down to this: Do I want to be in the military? Joining HPSP means you are joining the military with all its good and bad. You will be giving up a certain level of freedom to choose, but it is not the military's goal to make your life miserable. With the exception of primary care, pay will be lower in the military, but you have the opportunity to serve some of the best people our country has to offer. I don't think anyone here will dispute that we have a great patient population.

If you are flexible and have a strong desire to serve, HPSP is a good route. If you want what you want when you want it.......No. Stay away.

Very sensible advice. I am one of the very disgruntled, but this is along the lines of how I feel.

Also, I dont recall Homunculus being anti-HPSP? Clarify.

 

[NavyFP]

Very sensible advice. I am one of the very disgruntled, but this is along the lines of how I feel.

Also, I dont recall Homunculus being anti-HPSP? Clarify.

Who's ragging on the Caveman? If it is me, it is not intentional.

 

[Galo]

Who's ragging on the Caveman? If it is me, it is not intentional.

Was not you.

TIRED: "Even the moderator(s) of this forum are pretty ardently anti-HPSP."


So I just said clarify. I don't recall Homunculus jumping on the bash milmed bandwagon just yet. More specifically HPSP, unless he at some point said that you may not have a choice of specialty which is entirely true.

 

[met19]

There are many out there who like the program. Most do not post on this site. You decision will come down to this: Do I want to be in the military? Joining HPSP means you are joining the military with all its good and bad. You will be giving up a certain level of freedom to choose, but it is not the military's goal to make your life miserable. With the exception of primary care, pay will be lower in the military, but you have the opportunity to serve some of the best people our country has to offer. I don't think anyone here will dispute that we have a great patient population.

If you are flexible and have a strong desire to serve, HPSP is a good route. If you want what you want when you want it.......No. Stay away.

this is some of the best advice i have ever read or heard regarding HPSP. Every prospective should read this particular post. I wish I had this opinion when I was considering HPSP.

I'll admit I'm somewhat disgruntled, but the patient population rocks and you can see some really cool places courtsy of military dime (rota, naples). (Iraq is not really cool).

With the exception of the severly annoyed, I think most people's level of annoyance is variable. My disgruntlement changes based on the amt of BS forced to go through at any particularly moment. Though I admit I don't have the clinic responibilty that some really find annoying (AHLTA).

 

[orbitsurgMD]

this is some of the best advice i have ever read or heard regarding HPSP. Every prospective should read this particular post. I wish I had this opinion when I was considering HPSP.

I'll admit I'm somewhat disgruntled, but the patient population rocks and you can see some really cool places courtsy of military dime (rota, naples). (Iraq is not really cool).

With the exception of the severly annoyed, I think most people's level of annoyance is variable. My disgruntlement changes based on the amt of BS forced to go through at any particularly moment. Though I admit I don't have the clinic responibilty that some really find annoying (AHLTA).

True, but understand exactly what NavyFP is saying.

Wanting "what you want when you want it" is the most responsible way of thinking, as long as you want the right things for the right reasons. By contrast, wanting to be in the military to be in the military, or to have a select patient population may not be a very good thing at all.

As a medical student looking to residency, your priority should be to obtain the best possible training in the field you think yourself best suited. The Navy and other branches are not necessarily your allies in that effort. In fact, their interests are more often than not very divergent from yours at that point in your career. Now it may be seductive to be offered a "break" after your internship to go do other things besides PGY-2 training, that is understandable if you are coming out of nine years of undergrad, medical school and internship. But professionally, at this point in the history of medical education, it is not the best thing to be doing. What you probably need at that point is a nice vacation, not a three-year absence from training that removes you from the rigor and support of the most valuable phase in your professional formation as a physician.

The services pay lip service to training, and they deliberately mislead prospective applicants to the HPSP by touting training opportunities, but they fall far short on the delivery side of their promises. And that is really what matters, not the horn-blowing about how wonderful some new service being offered at one hospital or another is or how well their few residency graduates do on inservice and specialty boards exams. That stuff is all window dressing and is not what matters.

 

[orbitsurgMD]

True, but understand exactly what NavyFP is saying.

Wanting "what you want when you want it" is the most responsible way of thinking, as long as you want the right things for the right reasons. By contrast, wanting to be in the military to be in the military, or to have a select patient population may not be a very good thing at all.

As a medical student looking to residency, your priority should be to obtain the best possible training in the field you think yourself best suited. The Navy and other branches are not necessarily your allies in that effort. In fact, their interests are more often than not very divergent from yours at that point in your career. Now it may be seductive to be offered a "break" after your internship to go do other things besides PGY-2 training, that is understandable if you are coming out of nine years of undergrad, medical school and internship. But professionally, at this point in the history of medical education, it is not the best thing to be doing. What you probably need at that point is a nice vacation, not a three-year absence from training that removes you from the rigor and support of the most valuable phase in your professional formation as a physician.

The services pay lip service to training, and they deliberately mislead prospective applicants to the HPSP by touting training opportunities, but they fall far short on the delivery side of their promises. And that is really what matters, not the horn-blowing about how wonderful some new service being offered at one hospital is or another or how well their few residency graduates do on inservice and specialty boards exams. That stuff is all window dressing and is not what matters.

"If you are flexible and have a strong desire to serve, HPSP is a good route" says NavyFP. I really don't agree, here, because "flexibility" as it is applied also means a willingness to work as ordered, even if it means working with far less training as a physician than would be acceptable in any non-military setting. That is an ethical compromise in my opinion, one which the military in its discipline of orders can and does easily force you to make and one which those who shill for HPSP will never tell you about. Until the HPSP graduates are required to choose full training in the military or full deferment for civilian training, the HPSP program will remain suspect of and attractive to abuse.

 

[orbitsurgMD]

It's difficult to correlate your description of training with the reality of what I see in the hospital. Our surgeons seem to be, for the most part, highly skilled. Out of residency our guys go to some of the top fellowships in the nation and (at least by all accounts) do quite well. Of the few "questionable" surgeons I have enountered, most seem to have done civilian residencies.

So if we're not judging programs based on inservice scores, specialty board exam, or services offered, what exactly are you basing your argument of substandard training on?

I wasn't making the argument that the training programs were substandard. I was making the case that many HPSP candidates are denied the opportunity to complete their training, either as military residents or as deferred civilian residents until their obligations are repaid and they leave the services.

The quality of the military residency programs themselves isn't the issue--they may or may not be as good as you say-- but rather to the fact the quality markers I mentioned are used by recruiters to imply that the HPSP candidate can expect to receive from the services a complete and quality training experience or be deferred for the same. If only a small number of PGY-2 slots are available as either in-service positions or as deferral positions and a large number of HPSP internship-graduates are terminating their active-duty service as GMOs, whether that is their intention or not, then the quality of the military's residency training has little bearing on the experience of the HPSP graduate sent to the fleet; he's not getting the benefit of that training.

If you want to make comparisons of quality markers, there is a way to show my point: compare the percentage of military active-duty physicians board-certified in any specialty recognized by the ABMS (lets exclude interns and residents) with a large civilian multi-specialty medical practice like Southern California Permanente Medical Group, or all Permanente medical groups nationwide.

The point is that HPSP program has been used primarily as a feedstock for GMO assignments and only secondarily as a personnel source for military residency training and specialty staffing.

As for going to top fellowships, military residents have at least two advantages as applicants that set them apart from civilian applicants: they come with a paycheck provided by the military and they already have a job to follow their fellowship. I am sure they are competitive in many other respects, but the prepaid salary and the assurance of a job that takes them away from the area of training are very important to fellowship preceptors at selection time.

 

[NavyFP]

True, but understand exactly what NavyFP is saying.

Wanting "what you want when you want it" is the most responsible way of thinking, as long as you want the right things for the right reasons. By contrast, wanting to be in the military to be in the military, or to have a select patient population may not be a very good thing at all.

As a medical student looking to residency, your priority should be to obtain the best possible training in the field you think yourself best suited. The Navy and other branches are not necessarily your allies in that effort. In fact, their interests are more often than not very divergent from yours at that point in your career. Now it may be seductive to be offered a "break" after your internship to go do other things besides PGY-2 training, that is understandable if you are coming out of nine years of undergrad, medical school and internship. But professionally, at this point in the history of medical education, it is not the best thing to be doing. What you probably need at that point is a nice vacation, not a three-year absence from training that removes you from the rigor and support of the most valuable phase in your professional formation as a physician.

The services pay lip service to training, and they deliberately mislead prospective applicants to the HPSP by touting training opportunities, but they fall far short on the delivery side of their promises. And that is really what matters, not the horn-blowing about how wonderful some new service being offered at one hospital or another is or how well their few residency graduates do on inservice and specialty boards exams. That stuff is all window dressing and is not what matters.

Not quite what I was saying. If you have a specific path that must be followed to the letter in order to be content.... for example I must do a General Surgery residency at X hospital, complete training and then go to hospital Y after that and if hospital Z or assignment W comes up.... well life has all gone to heck and is intolerable. This doesn't work with the military. I also think this is one of the primary gripes.

Do recruiters mislead? Probably. Do applicants hear what they want to hear? Yes, there is some of that too. I truly want all students who accept HPSP to understand what they are entering. If they did, there would be fewer angry people on the other end.

 

[met19]

Not quite what I was saying. If you have a specific path that must be followed to the letter in order to be content.... for example I must do a General Surgery residency at X hospital, complete training and then go to hospital Y after that and if hospital Z or assignment W comes up.... well life has all gone to heck and is intolerable. This doesn't work with the military. I also think this is one of the primary gripes.

Do recruiters mislead? Probably. Do applicants hear what they want to hear? Yes, there is some of that too. I truly want all students who accept HPSP to understand what they are entering. If they did, there would be fewer angry people on the other end.

The problem is mainly recruiters. My recruiter was a Petty officer 1st class. She didn't know enough about the program, and appealed to "what I wanted to hear". So even though applicants hear what they want, the recruiter feeds into that to meet program goals.

I will admit I wasn't the greatest program shopper (in terms of really being aggressive enough). I would argue that applicants need to have more contact with students/MDs going thru the program and recuiters need more knoweldge about the program. My recruiter had no idea about the 8 year ADO. Now I've seen posts by NavyFP regarding how hard a concept this is to grasp. And it is difficult- it took me a while to understand. However, giving that understanding to recruiters shouldn't be impossible.

But perhaps recruiters wouldn't really be forthcoming about the 8 yr ADO since the military needs numbers.

Below is some food for thought.

I was Navy HPSP, rotated at Bethesda in a int med sub I and at portsmouth for EM. I ended up getting full deferment for EM. I felt that Navy EM programs were weak (not enough pathology, mainly uniform healthly population, and not enough accuity). Now that doesn't mean they are bad programs- just not what I was looking for. Luckily I received a full deferrment and will receive the training I want prior to full active duty.

 

[NavyFP]

The problem is mainly recruiters. My recruiter was a Petty officer 1st class. She didn't know enough about the program, and appealed to "what I wanted to hear". So even though applicants hear what they want, the recruiter feeds into that to meet program goals.

I will admit I wasn't the greatest program shopper (in terms of really being aggressive enough). I would argue that applicants need to have more contact with students/MDs going thru the program and recuiters need more knoweldge about the program. My recruiter had no idea about the 8 year ADO. Now I've seen posts by NavyFP regarding how hard a concept this is to grasp. And it is difficult- it took me a while to understand. However, giving that understanding to recruiters shouldn't be impossible.

But perhaps recruiters wouldn't really be forthcoming about the 8 yr ADO since the military needs numbers.

Below is some food for thought.

I was Navy HPSP, rotated at Bethesda in a int med sub I and at portsmouth for EM. I ended up getting full deferment for EM. I felt that Navy EM programs were weak (not enough pathology, mainly uniform healthly population, and not enough accuity). Now that doesn't mean they are bad programs- just not what I was looking for. Luckily I received a full deferrment and will receive the training I want prior to full active duty.

Just to clarify, there is no 8 yr Active Duty Obligation (ADO). No one who signs up for HPSP is required to be on active duty for 8 years. Depending on circumstances such as residency, GMO time and payback, many may spend 8 years on AD, but for someone in your situation (assuming you have a 4 year HPSP) you would only need to spend 4 years on Active Duty and 4 years in the Individual Ready Reserve. The 8 years of commissioned service clock starts the day you go on active duty (first set of real orders) and ends 8 years later. At that time you can resign your commission and part ways with the services.

I agree that recruiters are, by nature, going to emphasize what you want to hear and downplay what you don't. One problem I have faced with applicants I have talked with over the years is that even when you present the whole truth (with all the zits) they still have a belief that they will be the special case that gets exactly what they want. Everyone going to medical school is "special". It is a different league and you may not be an all star at this level.

 

[met19]

Just to clarify, there is no 8 yr Active Duty Obligation (ADO). No one who signs up for HPSP is required to be on active duty for 8 years. Depending on circumstances such as residency, GMO time and payback, many may spend 8 years on AD, but for someone in your situation (assuming you have a 4 year HPSP) you would only need to spend 4 years on Active Duty and 4 years in the Individual Ready Reserve. The 8 years of commissioned service clock starts the day you go on active duty (first set of real orders) and ends 8 years later. At that time you can resign your commission and part ways with the services.

I agree that recruiters are, by nature, going to emphasize what you want to hear and downplay what you don't. One problem I have faced with applicants I have talked with over the years is that even when you present the whole truth (with all the zits) they still have a belief that they will be the special case that gets exactly what they want. Everyone going to medical school is "special". It is a different league and you may not be an all star at this level.

Thats what I meant- my bad. Used poor terminology. I remember my recruiter not even mentioning the IRR. Just 4 years pay back. Now thats not a huge issue- my complaint or wish for future students is for the recruiters to be 1) more honest/straight fowards (less like a recruiter). and 2) more informed about how the program works. Thouhg the applicants need to do better research.

I find the idea of moving around a bit not to be such a negative. As of now I don't see my self as a west cost type person (im east coast)- but I might love it. It gives new experiences which (people might not take) is a huge benefit that HPSP offers.

 

[TheDoctorisin]

How does your first duty station selection work? How much input do you have? Are European or Korea stations available?