basic HPSP questions

[qqq]

Please forgive my lack of knowledge about HPSP. I have a few basic questions about HPSP. I am not yet in medical school but I have an understanding of the military. Thanks in advance.

Let's assume someone has done well in medical school and wants to enter a competitive specialty that is not something the military needs:

1. Will the military let that person do the internship that they want to do to set them up for the specialty they want to enter? Or will they be put into any internship that is available?

2. Can they do a military or civilian internship? Why would one choose a civilian over a military internship, or vice versa.

3. Regarding residency, does one have a choice to do a civilian residency? If so, why would someone choose a military residency over a civilian residency?

4. If a person can't do their residency of choice after internship, how long do they have to be a GMO before they can reapply for residency? If they had a 7 yr active duty commitment, is it possible that they could continually not be allowed to do the residency they want and so they end up being a GMO for 7 years?

5. If the person got out after 7 years as a GMO, would their career dreams of being in their competitive specialty be over?

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[texdrake]

I will answer these here, but also will add it onto my FAQ thread.

Internship and residency are two different things. If you are selected for FYGME (military intership year) you must do it. Also most people ARE selected. Your FYGME will either be in your field or done as a traditional rotating intership year.

You are required to apply to military residencies, if you don't match in your field you can defer out and do a civilian residency after your FYGME year. Military residencies are a little bit less intense (more book time, but you see a little less). You also get paid about 20K more per year in the military.

If you don't match after your FYGME year you are automatically deffered, the military will not make you train in a field you don't want to.

Some people choose to get out as quickly as possible by delaying their residency and completing the rest of their commitment as a GMO. This of course delays your training quite a bit and pays more than a resident, but not a bunch. It does get you out quicker though.

The answer to your last question is probably YES. Not many residencies are going to be looking for a guy who has spend 7 years treating a fairly healthy population of patients. I don' t think it would hurt that much in primary care, but specialties would be very difficult.

Oh and where is the 7 year committment coming from??? ROTC???

 

[Mirror Form]

Please forgive my lack of knowledge about HPSP. I have a few basic questions about HPSP. I am not yet in medical school but I have an understanding of the military. Thanks in advance.

Let's assume someone has done well in medical school and wants to enter a competitive specialty that is not something the military needs:

The military has pretty much all forms of specialties (at least the ones you would do in residency). I can't think of a single field that was not available to me when I was applying. Perhaps Rad Onc wasn't, although I'm not 100% sure what the deal with that field is.

The real question is this: what happens if you don't match in the military's system?

Well, it depends. First you would apply for a civilian deferment. For example, lets say you were in the air force and applying for ophthalmology. The air force usually trains three people at an air force hospital's residency program, and then gives out three civ deferments each year. Although depending on the needs of the air force, they may give out more or less. They'll let you know before the match how many civ deferments will be given out, I think there were more then three last year. The army is a bit more sketchy with the civ deferments. They give them out sometimes, but it's less organized. However, the army trains a lot more people in it's GME programs and most competitive specialties are easier to get into in the army then in the civ world. Therefore, in most specialties, if you don't match at the army's residency program, you probably won't match into a civilian one. There are a few exceptions though (eg PMR).

If you don't get a civilian deferement, you'll do either a traditional internship in the militaryor or a traditional civilian one. Afterward you'll have to do a 1-2 yr GMO tour. Then you can either reapply (you'll be much more competitive in the military's match system after having done a GMO tour). Or, you can just finish all four years as a GMO and then apply for a civilian residency.

I think that in most civilian residency fields, having done four years as a GMO would give you a step up in the application process. It would definitely make you stand out from the typical applicants.

As far as the Navy goes, avoid it unless you want to do a GMO tour before residency.

 

[Mirror Form]

Military residencies are a little bit less intense (more book time, but you see a little less).

This is often true. That said, it's so highly variable that I don't think we should use it as a generalization.

If you don't match after your FYGME year you are automatically deffered, the military will not make you train in a field you don't want to.

The military will not make you train in a field that you don't want to. However, you don't automatically get a deferment. You have to apply for one, which is actually done concurrently with the military's match. So if you don't match with the military, and the military doesn't need additional people in that field (of if you don't get any of the civ deferments that they give out), then you'll be doing a GMO tour.

 

[texdrake]

I haven't heard of anyone doing a GMO tour that wasn't in the Navy or did not choose to do one. Doesn't mean it doesn't happen, but I haven't heard of it.

 

[qqq]

I haven't heard of anyone doing a GMO tour that wasn't in the Navy or did not choose to do one. Doesn't mean it doesn't happen, but I haven't heard of it.

So if they didn't do a GMO tour then that means all the non-navy people you know got the residency of their choice? or at least went into a residency that might not be their choice of specialty instead of going GMO? (I would hate to pick a specialty using that reasoning).

Thanks for all your help guys, now I have a few more questions:

1.) So by "civilian deferment" you mean that . . . wait, what do you mean? Do you mean that one defers their residency, while in the mean time doing a GMO tour, and then after their GMO tour is done they are guaranteed a residency slot in a civilian residency? Any civilian residency program in the country? And after residency they would have a little bit less time in the military because they already served some of their commitment as a GMO?

2.) It is mandatory that one applies for a military residency. And Texdrake said that most people match in the military system. This is good then, right? I should not have to worry about not matching because I have a really good chance at matching, right?

3.) So now, let's say one doesn't match in the military system and they don't get a civ deferment. They want a specialty that is not really needed by the military, and there are also not many slots available (BUT, as said by Sledge there is at least 1 slot because the military has all forms of specialties that the civilian world has, except maybe rad onc). So now I still don't need to worry because all I have to do is do a short 1-2 year GMO tour, and now I come back and am super competitive and will likely get the slot? Is this correct?

4.) Texdrake said that 7 years as a GMO would hurt a person's chance of getting into a civ residency once out of the military. Sledge said that 4 years would actually give a person a leg up on the competition. So the 3 additional years serving as a GMO would really make that much of a difference? (7 year commitment is coming from 4 HPSP + 3 prior commitment from commissioning source).

Thanks for your help guys. As you can see I am trying to assuage my concerns that, in military medicine, I might not be able to do the specialty I want. I wouldn't mind much if I had to do a GMO tour, I just want to know that I will be able to have the same opportunities as my civilian counterparts at SOME point in time.

 

[qqq]

Oops I think I misread Texdrake. So most people match FYGME but not necessarily for residency.

 

[bobbyseal]

I haven't heard of anyone doing a GMO tour that wasn't in the Navy or did not choose to do one. Doesn't mean it doesn't happen, but I haven't heard of it.

I know of an airforce guy who didn't get a civilian deferment for his choice of specialty. He matched in a transitional internship. He'll likely be a flight surgeon.

 

[Mirror Form]

(7 year commitment is coming from 4 HPSP + 3 prior commitment from commissioning source).

I'll reply more later. However, WARNING, is your three year commitment from ROTC? If so, there are some unique reasons why you should definitely think twice about taking the HPSP scholarship. BTW, which branch are you? If we knew, then we could answer your questions a lot better. It's pointless to give three different answers (one for each branch) to each question, if you're already locked into a particular branch by your prior commitment.

 

[Biodork111]

I have been working on my application for the HPSP through the Navy.

Here is the deal...

Once I'm done with school would I definitely have to do a GMO? Its not that I'm afraid to serve, I just have family committments that I cannot set on the back burner. Everything I've read about the program thus far says that some people do them, and some people don't. And usually the people who do indeed do GMOs, have opted to do them because they wanted to. I really need to get all my facts straight before I do this, and I have a feeling that the recruiter is not always 100% straight forward with me (obviously).

I was under the impression that I go to school for 4 years, do my residency (either military or civilian) and then serve my 4 years of active duty. (I am aware of the 45 days a year commitment while in school). Am I just being really naive about this whole thing? Should I look into doing this through another branch of the military?

BTW...I plan to enter pediatrics specializing in the developmentally disabled. If that helps answer any of these questions.

 

[Mirror Form]

Once I'm done with school would I definitely have to do a GMO? Its not that I'm afraid to serve, I just have family committments that I cannot set on the back burner. Everything I've read about the program thus far says that some people do them, and some people don't. And usually the people who do indeed do GMOs, have opted to do them because they wanted to. I really need to get all my facts straight before I do this, and I have a feeling that the recruiter is not always 100% straight forward with me (obviously).

If you don't want to do a GMO tour before residency, avoid the Navy. Not all Navy people do them, but a very large number do. Many competitive fields in the Navy are impossible to get into w/o doing a GMO first. This isn't so much the case for the army and air force. That said, doing a GMO can make you more competitive for fields that you might not be able to match into otherwise.

I was under the impression that I go to school for 4 years, do my residency (either military or civilian) and then serve my 4 years of active duty. (I am aware of the 45 days a year commitment while in school). Am I just being really naive about this whole thing? Should I look into doing this through another branch of the military?

well, it's not the simple. There are other threads on here the explain how residency and gmo tours can affect and lengthen your commitment. So do a search and check the faq. Feel free to PM me if the threads don't make things clear.

 

[Mirror Form]

I haven't heard of anyone doing a GMO tour that wasn't in the Navy or did not choose to do one. Doesn't mean it doesn't happen, but I haven't heard of it.

I know one air force person in my class that failed to match in anesthesia, and is now going to have to do a GMO tour. Although it's much more rare for the army, I do one of one guy who didn't match in PMR and had no choice but to do a GMO tour. Thats the exception in the army though.

 

[Mirror Form]

So if they didn't do a GMO tour then that means all the non-navy people you know got the residency of their choice? or at least went into a residency that might not be their choice of specialty instead of going GMO? (I would hate to pick a specialty using that reasoning).

yes, or they were at least given a "civilian deferment."

1.) So by "civilian deferment" you mean that . . . wait, what do you mean? Do you mean that one defers their residency, while in the mean time doing a GMO tour, and then after their GMO tour is done they are guaranteed a residency slot in a civilian residency? Any civilian residency program in the country? And after residency they would have a little bit less time in the military because they already served some of their commitment as a GMO?

No, a "civilian deferment" means that army (or whichever branch) allows you to just apply to a civilian residency program through the standard civilian match. There are different types of deferments. In the army, the most common type is one where you are basically just given four years (or how ever long your residency period is) off. Then you reactivate once you've finsihed your residency. If you don't match into any civilian programs (this occasionally happens with competitive fields), then you'll probably end up doing a gmo tour.

2.) It is mandatory that one applies for a military residency. And Texdrake said that most people match in the military system. This is good then, right? I should not have to worry about not matching because I have a really good chance at matching, right?

Yes, if you're in the Army. No, if you're in the Air Force.

3.) So now, let's say one doesn't match in the military system and they don't get a civ deferment. They want a specialty that is not really needed by the military, and there are also not many slots available (BUT, as said by Sledge there is at least 1 slot because the military has all forms of specialties that the civilian world has, except maybe rad onc). So now I still don't need to worry because all I have to do is do a short 1-2 year GMO tour, and now I come back and am super competitive and will likely get the slot? Is this correct?

You'll definitely have an advantage. However, it's not guaranteed. For example, there are plenty of people who do GMO tours but still don't match into derm. Also, for some reason PMR was really competitive last year (like 12 applicants for 3 slots, very weird). The guy I know who didn't match into PMR had actually just finished a two year gmo tour in the middle east. So now he's going to have to do another gmo tour (he hated his last one due to being so far away from his wife) and just get out of the army. That said, usually you'll get your field of choice, and you almost always will after a gmo tour. But there are exceptions (i.e., a couple people who get screwed).

4.) Texdrake said that 7 years as a GMO would hurt a person's chance of getting into a civ residency once out of the military. Sledge said that 4 years would actually give a person a leg up on the competition. So the 3 additional years serving as a GMO would really make that much of a difference? (7 year commitment is coming from 4 HPSP + 3 prior commitment from commissioning source).

Whether the GMO tour will help or hurt you is sort of a grey area. It really just depends on the specific residency program. I can't image it hurting you for the majority of programs. In most, it should give you some sort of edge. Although seven years is a pretty long time to be a GMO!

 

[qqq]

I'll reply more later. However, WARNING, is your three year commitment from ROTC? If so, there are some unique reasons why you should definitely think twice about taking the HPSP scholarship. BTW, which branch are you? If we knew, then we could answer your questions a lot better. It's pointless to give three different answers (one for each branch) to each question, if you're already locked into a particular branch by your prior commitment.

I got a 5 yr commitment from the USAF Academy. I'm currently serving right now and if I get a HPSP scholarshiop (AF board for active duty folks is April) I will have served 2 years before entering med school this fall. So that is where the 3 years comes from. Please tell me what this warning is about!!

Also, as I posted somewhere else on this board, I want to do the HPSP because it will allow me to start medical school now, as opposed to waiting until my 3 years are up. I already have a hard fought acceptance and don't want to give it up. Although I have considered seeing if any of the schools I was accepted to will defer my admissions for 3 years. I doubt it. For AF, what is the minimum number of years you can take the HPSP scholarship?

So anyway, what's the warning about!? Thanks for all your replies.

 

[Mirror Form]

I got a 5 yr commitment from the USAF Academy. I'm currently serving right now and if I get a HPSP scholarshiop (AF board for active duty folks is April) I will have served 2 years before entering med school this fall. So that is where the 3 years comes from. Please tell me what this warning is about!!

If you went to the academy, then you should probably take the HPSP option.

I was thinking that maybe you had just finished a three year rotc scholarship. Had you done a three year ROTC scholarship, I was going to recommend you try to do medical school on your own dime by just applying for a education delay. That's b/c by doing HSPS, the four years in med school won't count as time in service toward your pay scale. Whereas, if you take an ed delay and pay for medical school yourself, I've heard that they do. Therefore, with the loss of an increased pay scale you get by doing HPSP, there isn't nearly as much of an incentive for signing up for the additional four years of service with HPSP.

Also, as a physician, if you decide to stay in the military past the end of your service commitment, you get a hefty bonus. This makes it so that even if you stay in the military for 30 years, you might not come ahead by taking the HSPS scholarship (depending on your med school's tuition of course).

 

[qqq]

You'll definitely have an advantage. However, it's not guaranteed. For example, there are plenty of people who do GMO tours but still don't match into derm. Also, for some reason PMR was really competitive last year (like 12 applicants for 3 slots, very weird). The guy I know who didn't match into PMR had actually just finished a two year gmo tour in the middle east. So now he's going to have to do another gmo tour (he hated his last one due to being so far away from his wife) and just get out of the army. That said, usually you'll get your field of choice, and you almost always will after a gmo tour. But there are exceptions (i.e., a couple people who get screwed).

Okay, well, since nothing in the military is guaranteed, then I guess this is as much reassurance as one can ask for. I'll just hope I'm not one of the guys that gets screwed even after doing his time as a GMO. thanks Sledge

 

[qqq]

Also, as a physician, if you decide to stay in the military past the end of your service commitment, you get a hefty bonus. This makes it so that even if you stay in the military for 30 years, you might not come ahead by taking the HSPS scholarship (depending on your med school's tuition of course).

How much is this bonus? Was/Will it be enough to persuade you (and your family) to continue to deploy/PCS?

 

[Mirror Form]

How much is this bonus?

The bonus depends on your specialty area. In my field, ophtho, it was raised last year from 15k / yr to 18k / yr. However, it's higher for higher paid specialties (anesthesia, rads, ortho, etc) and probably lower for fields like peds.

Was/Will it be enough to persuade you (and your family) to continue to deploy/PCS?

I doubt it's enough to have too big of an effect on people's decisions since you can always make more in the private sector then what the army offers. Although, once you've been in your field for awhile, you won't be deployed as much as the new guys. So if you've already paid off seven years commitment, you'll probably have already done one or two big deployments. If you specialty isn't getting killed, you'd have a good shot at avoiding too many more major deployments if you re-sign.

Also, I've heard that when people resign after their initial commitment is up, they can negotiate for better assignments.

 

[bjay27]

This may be a little biased, in that the majority reading this are doing HPSP's,
but if you were to compare a student applying for a residency:
A. Outside of the military (non HPSP)
B. Inside (part of the HPSPs)

Would you have more chances of getting your residency match if youre outside the military? From what I can gather, its easier to get matched in the military to non-competitive residencies, but just the opposite for competitive ones.
Thus, a derm or aneth match might be more likely for someone out of the HPSP programs, who can apply to whatever civilian places he wants?

note: I am not asking whether a certain residency is better in or out of the military, Im just asking how obtainable competitive residencies are between A and B.

Fellow AF HPSP applier,
Thanks

 

[AubreyMaturin]

According to my research, not experience,
This may or may not be true. It all depends on what the branch of service needs that year, or what they predict that they will need. It is possible that one year there may be 0 opportunities to go into a residency.

EM seems to be really easy to get into in the civilian world and a little more competitve in the military. But this could also change. IM is probably equal across the board. Rads, Derm are very competitve both ways. again these could change for the better or the worse. The military could decide that it is easier to subconrtact derm and elimiate all residencies completely, who knows. "Semer Gumby or stay cilivlian" I always say...no, wait. I stole that saying from someone else...

Someone previously wrote on this site, "In civilian practice there are a large number of applicants applying for a large number of residencies. In the military ther are a small number of applicants applying for a small number of residencies." So it also depends on how many applicants you get for a specific residency that year.

In my opinion, one advantage in the military is that if you don't match, you can wait a year or two or three, and do some genreal med officer stuff. Then apply as a more competitive applicant. I don't see this a s being as easy an option in the civilian world.

---------
"I did not spend 7 years in evil medical school to be called 'mister'."
- Dr. Evil

 

[Mirror Form]

Someone previously wrote on this site, "In civilian practice there are a large number of applicants applying for a large number of residencies. In the military ther are a small number of applicants applying for a small number of residencies." So it also depends on how many applicants you get for a specific residency that year.

Yep, so it's very variable. In general, you'll have the easiest time matching into your desired field if you're in the army though (compared to the other two brances and the civilian world). It's very variable though, last year rads didn't even fill (9 applicants for 10 slots), whereas PMR had 2-3x as many applicants as slots.