Army Match: Applying to civilian programs?

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dr zaius

dr zaius

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I can't seem to find any data or personal experiences from anyone. I'm planning to apply for urology in the 2014 military match, and I see that we are supposed to also apply to civilian programs. After looking at trends I am sure that I will not get a deferment with the Army (no one seems to), and if I don't match I will likely end up in a random PGY-1 spot. Is there any reason to apply to civilian programs? If so, does anyone recommend a certain number? It honestly seems like a waste of money, and my wife and I are putting our eggs in a certain geographic basket based on the military match.

Thanks in advance!
 
I'm not sure how urology was this year, but I know ortho had a few deferments. I will ask a friend who matched successfully into urology this year. Are you referring to the civilian urology programs that are VA and take some HPSP students? Or just civilian programs in general?

Here's the gist of it: When you submit ERAS, you select all the Army/DoD programs available to you. You pay for it and then get reimbursed. Normally you can apply to 10 hospitals for the base fee of $92. Because we get reimbursed for ERAS, we don't get to apply to any extra programs beyond the military ones for that initial $92. You have to apply to more programs on your own dime, which works out to another $92 for an extra 10. You can apply to as many or as few as you want. I didn't apply to any civilian ortho programs. I was banking on either landing a spot or doing an Army TY and reapplying during PGY1. Luckily I matched.

If you apply to civilian programs, you can still interview and go through the process. If you match military, you don't submit a rank list on NRMP/NMS and just withdraw yourself. If you get deferment, you go through the MD/DO match like all your civilian colleagues.
 
Every year it seems someone posts on here about they never conceived of getting a deferment and didn't plan on it, and now they're stuck. Don't be that guy.

Unless you can get a program director to look you in the eye and say something along the lines of "you will definitely match" or "there is no way you will match", then you should bite the bullet and apply to a handful of civilian programs. When you do, there's no need to be explicit about your military commitment (doesn't ERAS already ask you about any time you owe to the military?). Yes, it's a tremendous pain and it will likely waste your money, but that won't be the last time Uncle Sam does that to you. Just consider how much of a doofus you'll feel like for not spending the money if you're scrambling to apply to programs on December 16th.

If you feel confident that you'll match with the Army one way or another, then try to push off your interviews until after December 15th. I'm not sure what urology's interview season is like, but if programs are still interviewing in January that should work out for you since most applicants will want to interview relatively early.

If you withdraw from the match, then most programs will understand. When I contacted them about my withdraw, I expressly told them that I was obligated to apply in good faith in case I didn't match with the Army. It was easy to do because it was the truth.
 
colbgw02 said:
Every year it seems someone posts on here about they never conceived of getting a deferment and didn't plan on it, and now they're stuck. Don't be that guy.
Click to expand...

I totally have to agree. I know of someone that got a Deferement for OB/Gyn and hadnt even applied civilian and had to go to the rebuttal board and request to be placed in a Transitional Year. Its such a waste of money having to interview civilian, but if the Army actually gives you the opportunity to forgo a TY and GMO tour (3ish years) id take it especially if ur doing a specialty >5 years.
 
DoctaJMa said:
I totally have to agree. I know of someone that got a Deferement for OB/Gyn and hadnt even applied civilian and had to go to the rebuttal board and request to be placed in a Transitional Year.
Click to expand...

Of the two deferments for ortho I know, one was able to literally scramble into a civilian residency. The other made some calls but was told the interviewing season was over. That person did the rebuttal board and got a TY instead.

Once you do your ADTs, you will have a much better idea how you will do in the match. I was 99% sure I would match so I took a chance by putting all my eggs in the military basket. This was based on feedback I received as well as my observations. I was not told specifically where I was ranked or anything. But there was always a chance I wouldn't.

I was also under the assumption there wouldn't be any deferments. I was told repeatedly not to expect a deferment, that the number of training spots was sufficient to maintain appropriate levels of orthopods in the Army. Using my retrospectoscope, I probably should've thrown in some applications to other civilian programs just in case. I know it seems counterintuitive but looking at the way the match went for my civilian friends, 99% isn't enough of a guarantee to take the risk.
 
Thanks for the input. I think I have a pretty decent shot at matching based on numbers/research so long as I don't screw up on my externships. I'm going to go ahead and heed the advice though and apply to some civ spots to be safe. Thanks again, guys.
 
bleeker10 said:
Of the two deferments for ortho I know, one was able to literally scramble into a civilian residency. The other made some calls but was told the interviewing season was over. That person did the rebuttal board and got a TY instead.

Once you do your ADTs, you will have a much better idea how you will do in the match. I was 99% sure I would match so I took a chance by putting all my eggs in the military basket. This was based on feedback I received as well as my observations. I was not told specifically where I was ranked or anything. But there was always a chance I wouldn't.

I was also under the assumption there wouldn't be any deferments. I was told repeatedly not to expect a deferment, that the number of training spots was sufficient to maintain appropriate levels of orthopods in the Army. Using my retrospectoscope, I probably should've thrown in some applications to other civilian programs just in case. I know it seems counterintuitive but looking at the way the match went for my civilian friends, 99% isn't enough of a guarantee to take the risk.
Click to expand...
colbgw02 said:
Every year it seems someone posts on here about they never conceived of getting a deferment and didn't plan on it, and now they're stuck. Don't be that guy.

Unless you can get a program director to look you in the eye and say something along the lines of "you will definitely match" or "there is no way you will match", then you should bite the bullet and apply to a handful of civilian programs. When you do, there's no need to be explicit about your military commitment (doesn't ERAS already ask you about any time you owe to the military?). Yes, it's a tremendous pain and it will likely waste your money, but that won't be the last time Uncle Sam does that to you. Just consider how much of a doofus you'll feel like for not spending the money if you're scrambling to apply to programs on December 16th.

If you feel confident that you'll match with the Army one way or another, then try to push off your interviews until after December 15th. I'm not sure what urology's interview season is like, but if programs are still interviewing in January that should work out for you since most applicants will want to interview relatively early.

If you withdraw from the match, then most programs will understand. When I contacted them about my withdraw, I expressly told them that I was obligated to apply in good faith in case I didn't match with the Army. It was easy to do because it was the truth.
Click to expand...

Hi, I ran across this thread and I found all of your feedback to be very helpful. I have been considering whether to submit my application to the HPSP program, but have delayed doing so because of several reservations I have regarding how HPSP will affect my chances of getting into residency in the future; none of which could be adequately answered by the hpsp recruiter that I am working with. My questions are:


1. How HPSP affects admission into a civilian residency- Right now, I am very interested in EM. From what I've read, it is just as competitive (if not more competitive) to get into an army residency vs a civilian residency. With that being said, I am very risk adverse and would like to take all means to maximize my chances of getting into an EM residency (whether through Military or Civilian); which means that if I do decide to pursue an EM residency, I will most likely apply to both the military (by default) and civilian residency programs. Let us assume that I maintain the grades, recommendations, Step I scores, and other miscellaneous stats that would put me within the competitive range for most civilian and army EM residencies. a) If I decide to apply to civilian residencies while in the HPSP, how does the status of being an HPSP student affect my chances of getting into a civilian residency? b) Do civilian residencies see it as an advantage, disadvantage, or as a neutral factor? c) And must I disclose whether I am participating in the HPSP program to the civilian residencies that I am applying to? (This question would probably best be answered by an hpsp recipient who has actually applied and interviewed to civilian residency programs, but any meaningful advice from would be greatly appreciated. If you know somebody who fits the description, please forward this post).

2. I would really like to talk to a current resident/attending physician who has gone through the civilian deferral process for residency and talk about their experience (hardships, challenges, advantages, etc). Please send me a PM, and I'll be glad to hear your advice.

Thank you!
 
D0ct0rDee said:
Hi, I ran across this thread and I found all of your feedback to be very helpful. I have been considering whether to submit my application to the HPSP program, but have delayed doing so because of several reservations I have regarding how HPSP will affect my chances of getting into residency in the future; none of which could be adequately answered by the hpsp recruiter that I am working with. My questions are:


1. How HPSP affects admission into a civilian residency- Right now, I am very interested in EM. From what I've read, it is just as competitive (if not more competitive) to get into an army residency vs a civilian residency. With that being said, I am very risk adverse and would like to take all means to maximize my chances of getting into an EM residency (whether through Military or Civilian); which means that if I do decide to pursue an EM residency, I will most likely apply to both the military (by default) and civilian residency programs. Let us assume that I maintain the grades, recommendations, Step I scores, and other miscellaneous stats that would put me within the competitive range for most civilian and army EM residencies. a) If I decide to apply to civilian residencies while in the HPSP, how does the status of being an HPSP student affect my chances of getting into a civilian residency? b) Do civilian residencies see it as an advantage, disadvantage, or as a neutral factor? c) And must I disclose whether I am participating in the HPSP program to the civilian residencies that I am applying to? (This question would probably best be answered by an hpsp recipient who has actually applied and interviewed to civilian residency programs, but any meaningful advice from would be greatly appreciated. If you know somebody who fits the description, please forward this post).

2. I would really like to talk to a current resident/attending physician who has gone through the civilian deferral process for residency and talk about their experience (hardships, challenges, advantages, etc). Please send me a PM, and I'll be glad to hear your advice.

Thank you!
Click to expand...

I think you have a misunderstanding about what your obligations are vis-a-vis military residency if you accept HPSP.

As an HPSP student, you are required to participate in the military match. There are a lot of permutations depending on branch and specialty, but the bottom line is that the military gets first crack at you. If, for whatever reason, they decide they don't want you, then you go through the civilian match. The rub is that you won't know officially whether or not the military has chosen you for an internship, residency, or both until well into the civilian interview season. Accordingly, the conventional wisdom is that every HPSP applicant should hedge their bets by at least partially participating in the civilian match until you hear officially from the military. This is frustrating and costly, but necessary to avoid going unmatched in the case of an unexpected deferral.

Speaking more specifically, the Army tends to grant fewer civilian deferments than the Navy and the Air Force. The Army also doesn't allow you to ask for (i.e. rank) a deferment, meaning that they tend to be given out unexpectedly. There are games you can play with your rank order list and away rotations that might get you a deferment, but those games backfire a lot and people end up in GMO land or at their least favorite Army program more often than not. Army EM is very competitive, appreciably more competitive than civilian EM, so you can expect one of two outcomes: 1) you're a stellar applicant who gets chosen for continuous training at an Army program or 2) you're selected for an Army internship - usually a transitional year - during which you will reapply. If you're selected, then you proceed to PGY-2; if not, then you're a GMO. Under no circumstances should an Army HPSP student hope for or plan on receiving a civilian deferment; you're very likely to be disappointed.
 
colbgw02 said:
I think you have a misunderstanding about what your obligations are vis-a-vis military residency if you accept HPSP.

As an HPSP student, you are required to participate in the military match. There are a lot of permutations depending on branch and specialty, but the bottom line is that the military gets first crack at you. If, for whatever reason, they decide they don't want you, then you go through the civilian match. The rub is that you won't know officially whether or not the military has chosen you for an internship, residency, or both until well into the civilian interview season. Accordingly, the conventional wisdom is that every HPSP applicant should hedge their bets by at least partially participating in the civilian match until you hear officially from the military. This is frustrating and costly, but necessary to avoid going unmatched in the case of an unexpected deferral.

Speaking more specifically, the Army tends to grant fewer civilian deferments than the Navy and the Air Force. The Army also doesn't allow you to ask for (i.e. rank) a deferment, meaning that they tend to be given out unexpectedly. There are games you can play with your rank order list and away rotations that might get you a deferment, but those games backfire a lot and people end up in GMO land or at their least favorite Army program more often than not. Army EM is very competitive, appreciably more competitive than civilian EM, so you can expect one of two outcomes: 1) you're a stellar applicant who gets chosen for continuous training at an Army program or 2) you're selected for an Army internship - usually a transitional year - during which you will reapply. If you're selected, then you proceed to PGY-2; if not, then you're a GMO. Under no circumstances should an Army HPSP student hope for or plan on receiving a civilian deferment; you're very likely to be disappointed.
Click to expand...

Thank you for your reply. All the recruiters that I have talked to have been telling me that the Army would be the first do decide on where HPSP students match, but asserted that if I don't match, "civilian residencies are possible". Based from what you've explained about non-selectedHPSP residency candidates, however, it seems like the Army would rather see HPSP candidates go through a TY/GMO than to match into a civilian residency for that specialty. Personally, that's a path I would not like to take. Thank you for this information, I have a lot to consider. If you don't mind me asking, where did you get this information?

Happy New Year
 
D0ct0rDee said:
If you don't mind me asking, where did you get this information?
Click to expand...

Just my experience. I've spent a decent amount of time at some of the Army's largest medical centers with lots of GME. I see a lot of unmatched interns (in the Army, almost exclusively transitional interns) who are reapplying in hopes of avoiding becoming a GMO. Every once in awhile, I'll run across an Army attending who was deferred for a civilian residency, but that's rare and - more importantly - highly unpredictable. I don't have a great idea of why the Army is like that, except I think the size and scope of its GME programs more closely align with its needs. Conversely, being smaller branches, the Air Force and Navy are more likely to be susceptible to manpower fluctuations that might require training that its GME can't immediately support. Some of it is probably cultural, too - the Army is stubborn and just refuses to grant deferments because it thinks its programs make better "physician officers". Though, again, that's just an impression.
 
colbgw02 said:
Just my experience. I've spent a decent amount of time at some of the Army's largest medical centers with lots of GME. I see a lot of unmatched interns (in the Army, almost exclusively transitional interns) who are reapplying in hopes of avoiding becoming a GMO. Every once in awhile, I'll run across an Army attending who was deferred for a civilian residency, but that's rare and - more importantly - highly unpredictable. I don't have a great idea of why the Army is like that, except I think the size and scope of its GME programs more closely align with its needs. Conversely, being smaller branches, the Air Force and Navy are more likely to be susceptible to manpower fluctuations that might require training that its GME can't immediately support. Some of it is probably cultural, too - the Army is stubborn and just refuses to grant deferments because it thinks its programs make better "physician officers". Though, again, that's just an impression.
Click to expand...

Thanks for sharing, . So correct me if I am wrong, but from your observations, it seems as if the Army would rather send an unmatched recruit through a TY rather than issue a deferral for residency?
 
colbgw02 said:
Absolutely. And it's not close. Gotta keep feeding that GMO pipeline.
Click to expand...
That seems like a very counterproductive strategy for the Army in the long run, since the organization would be forgoing the specialization of its physicians. However, I can also see how the Army opts to keep GMO's for the army's medical needs: they are cheaper and less likely to leave (no specialty= basically no jobs in the civilian world). From your experience, of those individuals who do a TY, what portion of them end up doing a GMO instead of matching in subsequent years?
 
D0ct0rDee said:
That seems like a very counterproductive strategy for the Army in the long run, since the organization would be forgoing the specialization of its physicians. However, I can also see how the Army opts to keep GMO's for the army's medical needs: they are cheaper and less likely to leave (no specialty= basically no jobs in the civilian world). From your experience, of those individuals who do a TY, what portion of them end up doing a GMO instead of matching in subsequent years?
Click to expand...

I think you'll find that the Army excels at long-term counterproductive strategies. Generally, short-term results are what get people promoted, especially as no one tends to keep the same job for more than 3 or 4 years.

To be clear, there are many transitional interns who have signed continuous contracts and will never be GMOs or have to worry about reapplying. To answer your question among the TY interns unmatched to a residency, I don't think I can give you a reliable number. Like many things in the military match, variability is high. In my transitional group, only 2 out of 10 didn't have a residency and both ended up GMOs. The following year, the transitional group at the same hospital was 20 with fully half of them unmatched.
 
colbgw02 said:
I think you'll find that the Army excels at long-term counterproductive strategies. Generally, short-term results are what get people promoted, especially as no one tends to keep the same job for more than 3 or 4 years.

To be clear, there are many transitional interns who have signed continuous contracts and will never be GMOs or have to worry about reapplying. To answer your question among the TY interns unmatched to a residency, I don't think I can give you a reliable number. Like many things in the military match, variability is high. In my transitional group, only 2 out of 10 didn't have a residency and both ended up GMOs. The following year, the transitional group at the same hospital was 20 with fully half of them unmatched.
Click to expand...


Thank you for your input, I found this very helpful. You mentioned that you practiced at several large military medical centers. How did your experience in these facilities differ from their civilian counterparts?
 
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