chance of civilian deferment/ getting what I'm qualified for?

[Strider_91]

---

Members don't see this ad.

Hi all,
I have read through the stickies and have seen the cons of taking the hpsp (deployment, bureaucracy, skill atrophy, gmo, no control over where you live).
I recently got into a solid state MD school but it will still cost me 160k for 4 years without factoring in living expenses and I have 30k in undergrad loans gaining interest and it gives me a ton of anxiety so I am thinking of taking the hpsp.

I sort of know the suck of the military, as my brother was an officer and I would take joy in caring for our soldiers although I would also take joy in caring for a civilian.

I could live with a deployment, bureaucracy, living somewhere that sucks etc because I know that is what I'm signing up for. What I cannot live with is being qualified to do a specialty that I want in the civilian world and having the military not giving me a deferment for it or letting me do it with them. Does anyone have hard data on match % in the navy? How likely is a GMO coming from a solid MD school with a solid resume?

My thoughts for what I can see myself doing in life are EM, pain magenemt either through anesthesia or Pmr (I know military doesn't train Pmr for some reason) or some type of surgical specialty like urology or ENT. I'm just a dumb pre med though so this can all change.
I know the military can totally screw you according to these threads but how often do they actually do that and not give what you want even though you would be able to match as a civilian?

 

[j4pac]

Is your $170000 including interest? Because $200000 is a drop in the hat for an attending physician.

If you sign up for HPSP, do it because you want to serve. Don't do it out of fear of not being able to pay your bills. I know too many to count physicians, and some complain about loans, but they aren't starving. You'll be fine.

 

[Strider_91]

Is your $170000 including interest? Because $200000 is a drop in the hat for an attending physician.

If you sign up for HPSP, do it because you want to serve. Don't do it out of fear of not being able to pay your bills. I know too many to count physicians, and some complain about loans, but they aren't starving. You'll be fine.

No it is not including interest, my tuition alone will cost 160k for school. I have not yet calculated it with interest but will do so. Thank you for your input.

 

[j4pac]

No it is not including interest, my tuition alone will cost 160k for school. I have not yet calculated it with interest but will do so. Thank you for your input.

Keep in mind that there are other ways to reduce your loan burden other than the military. If you are interested in finances as a physician I highly recommend reading White Coat investor, plus/minus Bogleheads guide to investing. Quite honestly, they should be medical school required curriculum. If you have the time...read at least WCI. It took me a few days to read....priceless.

 

[Strider_91]

Keep in mind that there are other ways to reduce your loan burden other than the military. If you are interested in finances as a physician I highly recommend reading White Coat investor, plus/minus Bogleheads guide to investing. Quite honestly, they should be medical school required curriculum. If you have the time...read at least WCI. It took me a few days to read....priceless.

I have read that book, it was very good but as I recall he was a military doc and it "ended up costing him money." At the time his interest rates were far better and his school was likely cheaper. I am also going to live at home and worried about the burden I will be on my parents that the monthly stipend would relieve.

Can you speak to the chances of them telling you that you can't do the residency you want or a civilian deferment?

Edited for spelling

 

[Onefellswoop87]

I have read that book, it was very good but as I recall he was a military doc and it "ended up costing him money." At the time his interest rates were far better and his school was likely cheaper. I am also going to live at home and worried about the burden I will be on my parents that the monthly stipend would relieve.

Can you speak to the chances of them telling you that you can't do the residency you want or a civilian deferment?

Edited for spelling

The short/simple answer to your 2nd paragraph is: "No." (at least with any specifics or numbers)

But, the military will not decide for you to do a residency you do not apply for. They might place you into an internship you don't want. Such as, if they don't defer you, you apply for internal medicine residency/internship and you don't get selected, you could do a transitional internship.

We can't speak to chances or percentages for your eventual specialty when applying in 4 years. I can hardly speak to chances for a specific specialty this year or next. With so few applicants and spots (a few hundred total in the Navy compared to thousands nationwide in the civilian side), a very competitive pool or a not so competitive pool of applicants one year can drastically alter the average step scores, just for one example.

What kind of doctor you want to be when you grow up has a major factor in it. Family med? Yeah, they will have spots to train FPs. Rad onc? I don't think the Navy has that training active duty, and the need per year is low, so some years they defer for civilian training, but some years they don't train anyone. If the specific branch you join needs even more of specialty XYZ than they can train active duty, they defer or sponsor for civilian training.

The world stage also plays an enormous part into this. WWIII breaks out? We will need more physicians in general but you can expect the training pipelines for specific specialties to open up even more, relative to other specialties.

 

[Cooperd0g]

The military seems to adjust how many training spots are available for each specialty almost every year based on retention of current physicians and other factors. Sometimes this means more or less deferment spots. Sometimes it means none at all. Sometimes it actually means less in service spots along with no deferment spots. It seriously does vary from year to year. So no, no one can give you the odds of getting a deferment in your desired specialty. I know several people who had the grades to match into Ortho, Peds, EM, ENT, etc who are all doing TY or gen surg internships simply because they are in a much smaller pool of applicants and for some reason, be it grades or interview personality, didn't make the cut.

 

[Strider_91]

The military seems to adjust how many training spots are available for each specialty almost every year based on retention of current physicians and other factors. Sometimes this means more or less deferment spots. Sometimes it means none at all. Sometimes it actually means less in service spots along with no deferment spots. It seriously does vary from year to year. So no, no one can give you the odds of getting a deferment in your desired specialty. I know several people who had the grades to match into Ortho, Peds, EM, ENT, etc who are all doing TY or gen surg internships simply because they are in a much smaller pool of applicants and for some reason, be it grades or interview personality, didn't make the cut.

So what is the move for someone who wants to do ortho but there are no deferment spots/ they don't match? They do a gmo for 4 years and then get out and apply to do a civilian residency? They don't get forced to do a different residency right?

 

[Cooperd0g]

So what is the move for someone who wants to do ortho but there are no deferment spots/ they don't match? They do a gmo for 4 years and then get out and apply to do a civilian residency? They don't get forced to do a different residency right?

They do force you into an internship because you have to get licensed, but they don't force you to finish a residency. So your options are to apply to a back up residency or GMO and get out and try for a civilian position.

 

[Red Lobster Actual]

solid state MD school but it will still cost me 160k for 4 years without factoring in living expenses and I have 30k in undergrad loans gaining interest

Basically 230k-270k graduating debt. Most likely not subsidized and the loans running at 5-6% interest even after consolidation. Ouch.

I have read that book, it was very good but as I recall he was a military doc and it "ended up costing him money."

Another reason he lost money because he stayed to train in EM with the Air Force and served out his time as an attending. I think EM docs can make at least 2x in the civilian world than in the military.

GMO and get out and try for a civilian position.

From my personal experience (n = 4) of the EM physicians that did this they wound up alright. One wound up doing EM residency, another a tox fellow, and two others clinical faculty. All at UC San Diego.

 

[Strider_91]

Basically 230k-270k graduating debt. Most likely not subsidized and the loans running at 5-6% interest even after consolidation. Ouch.



Another reason he lost money because he stayed to train in EM with the Air Force and served out his time as an attending. I think EM docs can make at least 2x in the civilian world than in the military.



From my personal experience (n = 4) of the EM physicians that did this they wound up alright. One wound up doing EM residency, another a tox fellow, and two others clinical faculty. All at UC San Diego.

I put the actual numbers into an interest calculator and I will have 232k with interest calculated...that's including everything. Would you recommend taking the money, doing a GMO tour and then getting out and doing a residency?

 

[Gastrapathy]

**** no

 

[HighPriest]

Personally, I'd pay $232,000 right now if I could get the last 9 years of my life back from the Army. But, you know, that's hindsight.

 

[Strider_91]

Personally, I'd pay $232,000 right now if I could get the last 9 years of my life back from the Army. But, you know, that's hindsight.

I am trying to regret that feeling so I appreciate these forums. I am just very tempted due to being debt averse and it is giving me a ton of anxiety. It seems that either way I'm eating a **** sandwhich in some form or another. Would you agree the best option would be to wait and reconsider this in my residency when I have my actual job prospects and debt amount and can make a more informed decision? The only thing I would be missing out on financially would be the monthly stipend which would provide me a lot of comfort living at home the next 4 years, but I can't see that being worth the turmoil that many on these boards seem to be facing (no offense guys, I appreciate the true insight).

I just asked my friend who is in hpsp with the AF if he is worried about doing a GMO and he said "GMO? What's that?"- so I'm thankful for all of you who have come before me.

 

[HighPriest]

My opinion is that most people should wait until residency and consider FAP or a similar program alongside their other options for employment and possible debt reduction. Lots of employers will offer to pay down your debt along with a salary without the same type of commitment that the Army requires. If you end up as a family doc, then maybe the military will be a good deal. If you end up in ENT, it will usually not be the best option financially.

I was in a similar position - we all were (or at least, most of us were). $230k seems insurmountable when you're staging at it as an undergrad, eating ramen and hoping nothing goes wrong with your car. But while I still don't consider $230k to be peanuts, it's a very manageable number and is certainly worth less than my personal freedom and piece of mind.

 

[Strider_91]

My opinion is that most people should wait until residency and consider FAP or a similar program alongside their other options for employment and possible debt reduction. Lots of employers will offer to pay down your debt along with a salary without the same type of commitment that the Army requires. If you end up as a family doc, then maybe the military will be a good deal. If you end up in ENT, it will usually not be the best option financially.

I was in a similar position - we all were (or at least, most of us were). $230k seems insurmountable when you're staging at it as an undergrad, eating ramen and hoping nothing goes wrong with your car. But while I still don't consider $230k to be peanuts, it's a very manageable number and is certainly worth less than my personal freedom and piece of mind.

This sounds like very solid advice.

 

[Perrotfish]

My opinion is that most people should wait until residency and consider FAP or a similar program alongside their other options for employment and possible debt reduction. Lots of employers will offer to pay down your debt along with a salary without the same type of commitment that the Army requires. If you end up as a family doc, then maybe the military will be a good deal. If you end up in ENT, it will usually not be the best option financially.

I was in a similar position - we all were (or at least, most of us were). $230k seems insurmountable when you're staging at it as an undergrad, eating ramen and hoping nothing goes wrong with your car. But while I still don't consider $230k to be peanuts, it's a very manageable number and is certainly worth less than my personal freedom and piece of mind.

Again, its not 230K. That's the principle. With our current interest rates, tax rates, and debt compounding the day you take it out, the average physician will actually need to earn 3 times their principle (pretax) to pay down their debt. 700K still isn't insurmountable, but its a lot more than 230 K

FAP sounds like a good idea, but there are two key problems with it.
1) You get way, way less money for the same commitment. If I did FAP rather than HPSP I would have earned 120K in exchange for my 4 year commitment, which would have left me with a mere 280K worth of rapidly compounding debt to pay off on my own, on a military salary.
2) It doesn't really exist. Have you ever met ANYONE that came though this program? I haven't met one. They only have spots for a handful of specialties each year, and now we're overmanned in most specialties.

 

[Strider_91]

Again, its not 230K. That's the principle. With our current interest rates, tax rates, and debt compounding the day you take it out, the average physician will actually need to earn 3 times their principle (pretax) to pay down their debt. 700K still isn't insurmountable, but its a lot more than 230 K

FAP sounds like a good idea, but there are two key problems with it.
1) You get way, way less money for the same commitment. If I did FAP rather than HPSP I would have earned 120K in exchange for my 4 year commitment, which would have left me with a mere 280K worth of rapidly compounding debt to pay off on my own, on a military salary.
2) It doesn't really exist. Have you ever met ANYONE that came though this program? I haven't met one. They only have spots for a handful of specialties each year, and now we're overmanned in most specialties.

230k is what it will be the day I graduate with interest cause I will take at 40k at 6.8%. Game plan would be to just pay off the interest during my residency years (which will be hard, but maybe I'll have a wife who makes money and can help...idk?) and then it should still be 230k and gaining interest but hopefully my specialty will be lucrative and I will make around 300/year. With that salary it shouldn't take too long to pay off. I know I won't be living lavishly but I should be able to save for retirement and pay down my loans and live an above average life with this plan. Am I naive in thinking this?

My other worry is exactly what you're saying- you are over staffed in the specialties that usually get that scholarship so if it's over manned for them wouldn't that mean it would be almost impossible to match through hpsp anyway and then I'd get stuck going gmo?

I hope I do not come off rude or condescending I am just trying to get information.

 

[WernickeDO]

230k is what it will be the day I graduate with interest cause I will take at 40k at 6.8%. Game plan would be to just pay off the interest during my residency years (which will be hard, but maybe I'll have a wife who makes money and can help...idk?) and then it should still be 230k and gaining interest but hopefully my specialty will be lucrative and I will make around 300/year. With that salary it shouldn't take too long to pay off. I know I won't be living lavishly but I should be able to save for retirement and pay down my loans and live an above average life with this plan. Am I naive in thinking this?

My other worry is exactly what you're saying- you are over staffed in the specialties that usually get that scholarship so if it's over manned for them wouldn't that mean it would be almost impossible to match through hpsp anyway and then I'd get stuck going gmo?

I hope I do not come off rude or condescending I am just trying to get information.

Strider, ask yourself this: Are you willing to sacrifice your medical career to SERVE in the military? I promise you that it will involve sacrifice. That sacrifice may be where you live, where you go after residency, what residencies you have open to you, or when you are allowed to complete training. I promise you that the military is not interested in taking care of patients and things like GME and having an appropriate medical practice is far, far down the priority list. All in all, many people feel that military service is a duty; it's something that they feel compelled to do even in light of the sacrifices it entails. People like that will not be satisfied unless they take the plunge and join. Only you know if you have that desire, but I can also promise you that if having your loans taken care of is the main drive for joining (and if it is, that's okay), then you will regret joining on a daily basis. Are you prior military? If not, then you have no idea what you are getting into, and how could you?

What is your goal? Is it to become a competent physician and to build a medical practice, or is it to serve in the military as an officer? If it's the former, then stay far, far away from the military. If it's the latter, then go for it.

You hit the jackpot by being accepted to a state school. Yes it's a lot of money but it's still a lot less than some other schools. Debt is a major concern but living frugally for the first 5 years out of residency will wipe that debt away and put you on track to reaching your financial goals, whether that goal is early retirement, putting all of your kids through college, or buying a Lambo. Don't let fear of debt push you into joining the military.

In answer to your earlier question, you can't be pushed into a residency you don't want, but you can be cut off from a residency that you are qualified for. It is a smaller application pool and you have the wildcards of competing with people who were prior service, people who have completed GMO time, and people who have a family connection that trumps everything else. Again, if your goal is to be a competent doctor on your own terms then avoid the military.

 

[Strider_91]

Strider, ask yourself this: Are you willing to sacrifice your medical career to SERVE in the military? I promise you that it will involve sacrifice. That sacrifice may be where you live, where you go after residency, what residencies you have open to you, or when you are allowed to complete training. I promise you that the military is not interested in taking care of patients and things like GME and having an appropriate medical practice is far, far down the priority list. All in all, many people feel that military service is a duty; it's something that they feel compelled to do even in light of the sacrifices it entails. People like that will not be satisfied unless they take the plunge and join. Only you know if you have that desire, but I can also promise you that if having your loans taken care of is the main drive for joining (and if it is, that's okay), then you will regret joining on a daily basis. Are you prior military? If not, then you have no idea what you are getting into, and how could you?

What is your goal? Is it to become a competent physician and to build a medical practice, or is it to serve in the military as an officer? If it's the former, then stay far, far away from the military. If it's the latter, then go for it.

You hit the jackpot by being accepted to a state school. Yes it's a lot of money but it's still a lot less than some other schools. Debt is a major concern but living frugally for the first 5 years out of residency will wipe that debt away and put you on track to reaching your financial goals, whether that goal is early retirement, putting all of your kids through college, or buying a Lambo. Don't let fear of debt push you into joining the military.

In answer to your earlier question, you can't be pushed into a residency you don't want, but you can be cut off from a residency that you are qualified for. It is a smaller application pool and you have the wildcards of competing with people who were prior service, people who have completed GMO time, and people who have a family connection that trumps everything else. Again, if your goal is to be a competent doctor on your own terms then avoid the military.

Thank you for this informative post. I have seen you post many many years back as I have been reading these forums everyday and I appreciate you taking the time to inform pre meds. If I am being honest with myself, I would not be considering the military route if it were not for the debt I am facing. I cannot know what it is like to serve, but my brother went to West Point and served as an officer so I sort of saw what it's like. He complained a lot during it but he some pretty solid benefits after serving (as he should) but when I asked him if I should do it he said here's my advice on anything involving the military: don't do it.

For some reason it still seems appealing because of the money but at this point after all of this advice it seems to be a Poor decision. I find the temptation of no debt telling me "the grass is greener on the other side-they are complaining but they don't have debt so they don't get it." But I just can't listen to this notion; there are far too many people advising against it with my best interest in mind on these forums and my own brother (although he's not a physician).
I want to be a good physician first and foremost. I would love to take care of soldiers and their families but I don't see it giving me any more satisfaction than taking care of a civilian.
Thank you all for the advisement.

 

[HighPriest]

Again, its not 230K. That's the principle. With our current interest rates, tax rates, and debt compounding the day you take it out, the average physician will actually need to earn 3 times their principle (pretax) to pay down their debt. 700K still isn't insurmountable, but its a lot more than 230 K

FAP sounds like a good idea, but there are two key problems with it.
1) You get way, way less money for the same commitment. If I did FAP rather than HPSP I would have earned 120K in exchange for my 4 year commitment, which would have left me with a mere 280K worth of rapidly compounding debt to pay off on my own, on a military salary. If OP had stated that he was going to be $700k in debt, my reply would have been different. But I trust that he knows how to figure that out.


2) It doesn't really exist. Have you ever met ANYONE that came though this program? I haven't met one. They only have spots for a handful of specialties each year, and now we're overmanned in most specialties.

1. Read before you post. $232k is what OP posted as his debt at graduation. That's why I used the number. And if you have trouble paying off $280k (your number) on your military salary, or at least the interest, you need an accountant. If he had said his debt was $700k, I would have had a different reply, but I trust he knows how to figure that out. Incidentally, if he was certain he wanted to go into a primary care field, that would have changed my response as well.

2. The idea behind FAP in my book is that people don't take FAP. I don't think almost anyone should take a military scholarship because I think military medicine is s trainwreck. There are plenty of better options out there. While I agree, I haven't met anyone on FAP - I also have never met anyone from Burundi, but I believe they exist. However I've certainly met a TON of HPSP docs who regret having taken HPSP. I would also make the counter argument that you haven't met a lot of FAP guys because most people who make it into a civilian residency just don't consider it because there are better options. Maybe, maybe, for the guy who ends up in primary care who already has 5-10 years of prior experience HPSP is a good deal. Maybe for someone who wants to be in the military more than they want to practice medicine, it's a good deal (though I would argue that they just shouldn't practice medicine). If the only school you're accepted to is 60 grand/year, maybe you have an argument. Or, I suppose, for people who are averse to work?

You do realize that the vast majority of physicians out there did not take a military scholarship, and yet they are somehow not living on the street. Put down your Kool-aid for 5 minutes and consider the possibility that maybe there are other options. I considered HPSP. Hell, I did HPSP. It was a poor choice.

 

[HighPriest]

My other worry is exactly what you're saying- you are over staffed in the specialties that usually get that scholarship so if it's over manned for them wouldn't that mean it would be almost impossible to match through hpsp anyway and then I'd get stuck going gmo?

This will depend upon the year you apply, the branch of service you end up with, and the specialty to which you're applying. I have seen very good candidates rejected and sent to GMO-land and I have seen questionable candidates accepted based upon how competitive things are that year. This happens on the civilian side as well, although perhaps with a big less amplitude. What you'll see in the military is that one year everyone will apply for - let's say ENT - and the match rate will plummet (sometimes to as low as 1/4). The next year no one will apply because none of them want to be forced into a transitional year, and so the match rate will be something that is historically better than the civilian match. I had an excellent co-resident who matched my year who did not match the preceding year simply because of the numbers. He reapplied, but he did have to do an internship in a specialty he wasn't too keen on. Again, this sort of thing happens on the civilian side as well. Some people just don't get to do what they want to do. But you wouldn't do something like a GMO tour either.

 

[Red Lobster Actual]

What I cannot live with is being qualified to do a specialty that I want in the civilian world and having the military not giving me a deferment for it or letting me do it with them.

I put the actual numbers into an interest calculator and I will have 232k with interest calculated...that's including everything. Would you recommend taking the money, doing a GMO tour and then getting out and doing a residency?

This was my original plan before I matriculated into a school that prevented this plan from happening. However, service underpinned my decision to join the whole time since I discovered HPSP after being motivated to serve as opposed to having the debt point me towards HPSP. I think this distinction is important.

I only pointed out the option for Navy GMO and out plan because it seems like the more content physician veterans I've met are the ones that minimized their time inside the military. That this option is not only meant for failures and rejects. Heck, one of the posters on this thread did this and wound up at a really prestigious institution in addition to the ones I know personally (obvious observational bias here I know). You do well enough in medical school and your board scores you will be able to go into specialty you are qualified for and not be at the mercy of the military match via the GMO and out plan simply because you are eliminating the military from the equation. Of course matching into a specialty during a GMO tour has hardships of its own so it won't be perfect. On the other hand we now actually have a How To thread on this topic stickied on the top of this forum.

Again, above all else, there still should be the desire serve.

 

[narcusprince]

Again, its not 230K. That's the principle. With our current interest rates, tax rates, and debt compounding the day you take it out, the average physician will actually need to earn 3 times their principle (pretax) to pay down their debt. 700K still isn't insurmountable, but its a lot more than 230 K

FAP sounds like a good idea, but there are two key problems with it.
1) You get way, way less money for the same commitment. If I did FAP rather than HPSP I would have earned 120K in exchange for my 4 year commitment, which would have left me with a mere 280K worth of rapidly compounding debt to pay off on my own, on a military salary.
2) It doesn't really exist. Have you ever met ANYONE that came though this program? I haven't met one. They only have spots for a handful of specialties each year, and now we're overmanned in most specialties.

Parrotfish drinks the Navy kool-aid(im convinced he may be the special pays guy at bumed). He still thinks it's OK not to get his bonuses. 230k you can get deferments and pay your loan down while working. Also if you work for the VA or something similar your loans will be forgiven after 10 years of income based retirement. I have friends in Ortho/anesthesia/em who paid off their loans in one year. DO NOT JOIN for the money. I have seen fully trained excellent physicians hop out of major collateral duties because they had large families and good old MIL did not pay their bills so they had to seek outside employment with the spare time. DO NOT join if you want to roll the dice on residency training. JOIN because you want to be in the military. Also you have to consider as a fully trained physician you will be taking risk and receiving far less reward.

 

[Perrotfish]

1. Read before you post. $232k is what OP posted as his debt at graduation. That's why I used the number. And if you have trouble paying off $280k (your number) on your military salary, or at least the interest, you need an accountant. If he had said his debt was $700k, I would have had a different reply, but I trust he knows how to figure that out. Incidentally, if he was certain he wanted to go into a primary care field, that would have changed my response as well.

I read, I don't think you did. The OP said 160K with no interest and no living expenses. Which means 240K with no interest and living expenses with an insanely modest living expense budget of 20K/year. Which compounds at 7% interest per year after he takes the loans out, and during his repayment plan as an attending which means he will actually pay back 500K over a 10 year repayment plan. Which is paid with post tax dollars, so he will actually need to EARN 700k if he does only a 3 year residency and no fellowship. So 700 K.

You do realize that the vast majority of physicians out there did not take a military scholarship, and yet they are somehow not living on the street. Put down your Kool-aid for 5 minutes and consider the possibility that maybe there are other options. I considered HPSP. Hell, I did HPSP. It was a poor choice.

It probably was a crap choice when you joined, and it didn't help that you would have been making way more than your average doctor considering the profession you chose. But there is no historical precedent for how bad student loan debt has gotten. The first doctors to have their loan debt compound in medical school and residency, which doubled the effective student loan burden, graduated from three year residencies this year. None of those doctor you see 'not living on the street' have ever had to pay down anything remotely like this. Of course the students starting school now will have twice again they debt that the doctors graduating this year will have. The OP, who is going to go to a 'cheap' state school, is looking at paying back more than twice what the average student would have paid at the most expensive private school just 10 years ago.

I get that the grass is always greener, and I that there's a lot to be angry about in the military, but math is math. Is not joining a better choice? Maybe, depends on a lot of factors, definitely not a sure thing. Is FAP a better choice that HPSP? It will pay you nearly 250-500K less for the same 4 year commitment and will leave you in legitimate poverty, so no. Its not a viable option anymore.

 

[narcusprince]

I read, I don't think you did. The OP said 160K with no interest and no living expenses. Which means 240K with no interest and living expenses with an insanely modest living expense budget of 20K/year. Which compounds at 7% interest per year after he takes the loans out, and during his repayment plan as an attending which means he will actually pay back 500K over a 10 year repayment plan. Which is paid with post tax dollars, so he will actually need to EARN 700k if he does only a 3 year residency and no fellowship. So 700 K.




It probably was a crap choice when you joined, and it didn't help that you would have been making way more than your average doctor considering the profession you chose. But there is no historical precedent for how bad student loan debt has gotten. The first doctors to have their loan debt compound in medical school and residency, which doubled the effective student loan burden, graduated from three year residencies this year. None of those doctor you see 'not living on the street' have ever had to pay down anything remotely like this. Of course the students starting school now will have twice again they debt that the doctors graduating this year will have. The OP, who is going to go to a 'cheap' state school, is looking at paying back more than twice what the average student would have paid at the most expensive private school just 10 years ago.

I get that the grass is always greener, and I that there's a lot to be angry about in the military, but math is math. Is not joining a better choice? Maybe, depends on a lot of factors, definitely not a sure thing. Is FAP a better choice that HPSP? It will pay you nearly 250-500K less for the same 4 year commitment and will leave you in legitimate poverty, so no. Its not a viable option anymore.

Perrotfish you are an idiot who does not see the bigger mil med problems. I have worked in the civilian world as an attending and in the navy. My checks from the civilian world come on time the navy's may or may not. I hope you stick around miss a few bonuses and make admiral while some O-6 nurse is laughing at you. Money talks my op run from the military.

 

[Perrotfish]

Perrotfish you are an idiot who does not see the bigger mil med problems. I have worked in the civilian world as an attending and in the navy. My checks from the civilian world come on time the navy's may or may not. I hope you stick around miss a few bonuses and make admiral while some O-6 nurse is laughing at you. Money talks my op run from the military.

If you'd take a 500K paycut over 4 years to avoid a two month delay in your check then I don't think I'm the one missing the bigger picture. I'm not saying a military career makes sense, but the HPSP scholarship is a huge financial win for many medical students.

 

[j4pac]

I put the actual numbers into an interest calculator and I will have 232k with interest calculated...that's including everything. Would you recommend taking the money, doing a GMO tour and then getting out and doing a residency?

I know it seems like a lot of money. But It's not a lot of money. Be smart on your repayment strategy and you will be completely fine like the other 99 or so percent that don't go military.

If you join...join to serve. Otherwise, you will probably resent your decision and it could actually cost you more money in the end.

 

[pgg]

Have you ever met ANYONE that came though this program?

I've met exactly one person in my field who joined via FAP ... think he entered in 2005 or 2006. He seemed to be happy with the choice, but he got out when his FAP obligated time was up. I suspect there have been none since.


Perrotfish's math is correct. Medical school is MUCH more expensive now than it was 20 years ago, and average physician income is likely to decline in real after-tax dollars over the next 20. Whether those numbers sway someone toward or away from HPSP is another issue with many other factors, but the math is the math. HPSP is a better financial deal now than it used to be.

 

[narcusprince]

I've met exactly one person in my field who joined via FAP ... think he entered in 2005 or 2006. He seemed to be happy with the choice, but he got out when his FAP obligated time was up. I suspect there have been none since.


Perrotfish's math is correct. Medical school is MUCH more expensive now than it was 20 years ago, and average physician income is likely to decline in real after-tax dollars over the next 20. Whether those numbers sway someone toward or away from HPSP is another issue with many other factors, but the math is the math. HPSP is a better financial deal now than it used to be.

I won't deny it may be a better deal now. But even still it's a sore financial deal. And yes the bonuses matter for those in need. I have friends with 5 children and a wife whom once you divide his income is barely able to provide a decent life for kids and family. While for the work he does he should be making at least 3-4x what he is making now. I find the military has major problems with women and minorities. If your a single white male without children the military is a great life. I will say I have met some good people and lifelong friends. But overall it was a bad financial deal.

 

[Strider_91]

I read, I don't think you did. The OP said 160K with no interest and no living expenses. Which means 240K with no interest and living expenses with an insanely modest living expense budget of 20K/year. Which compounds at 7% interest per year after he takes the loans out, and during his repayment plan as an attending which means he will actually pay back 500K over a 10 year repayment plan. Which is paid with post tax dollars, so he will actually need to EARN 700k if he does only a 3 year residency and no fellowship. So 700 K.




It probably was a crap choice when you joined, and it didn't help that you would have been making way more than your average doctor considering the profession you chose. But there is no historical precedent for how bad student loan debt has gotten. The first doctors to have their loan debt compound in medical school and residency, which doubled the effective student loan burden, graduated from three year residencies this year. None of those doctor you see 'not living on the street' have ever had to pay down anything remotely like this. Of course the students starting school now will have twice again they debt that the doctors graduating this year will have. The OP, who is going to go to a 'cheap' state school, is looking at paying back more than twice what the average student would have paid at the most expensive private school just 10 years ago.

I get that the grass is always greener, and I that there's a lot to be angry about in the military, but math is math. Is not joining a better choice? Maybe, depends on a lot of factors, definitely not a sure thing. Is FAP a better choice that HPSP? It will pay you nearly 250-500K less for the same 4 year commitment and will leave you in legitimate poverty, so no. Its not a viable option anymore.

Did not mean to start an argument but your math may be right for the average student who Lives on their own but i am fortunate enough to live within 30 minutes of the school I got into so I am going to commute to save money. I'm pretty sure my parents will help me out with gas money and stuff and my car is payed off. Obviously they will let me eat their food. Basically I am hoping to not live off loans and only take out the bear minimum for tuition which will leave me at 232k when I graduate. Plus 30 from undergrad, but only 8 of that is gaining interest but I am working right now and plan to get rid of my unsubsidized undergrad loans.

The sick part is I went to a state undergrad too I just live in one of the most expensive states in the country for school...and everything. Can't wait to move.

Either way still a ton of money and the scholarship is tempting but I don't think I can live with the risk of not getting my specialty of choice. If I don't match where I want in civilian world it will be because im not qualified not because the year I graduate the military had no need for them.

At this point, it doesn't seem like the best option for me.
I have been hearing about people moving to BFE out of residency and landing very high paying jobs. That may be the new plan as of now.

 

[Gastrapathy]

I also met one FAP unicorn. Now an O6 reservist.

Doing the math before knowing your path is impossible. It depends on specialty choice, training opportunities and luck. It's unlikely to be a financial win but it is often the case that once you've stayed to ~10+, it's a financial mistake to leave. Despite that, most people choose to leave. Awful lot of people decide it's not worth the money.

 

[didja]

Sounds like the OP is settled and I think he or she made the right choice, since they were considering navy. But I'll speak some truth here- if they had landed an AF spot I'd tell them to at least consider it.

Although not broadcasted on this forum much, some of us have great military careers (usually in the Air Force) with great assignments, residencies and fellowships working with great colleagues. We get our gi bill transferred for our kids, get a nice little retirement set up and in my case I have a ton of great options to slide into when I reach twenty in a couple of years. That's the tug that keeps many people applying for hpsp- the chance at having some financial security early in their career while serving their country and not getting screwed (beyond deployments and being told where to live, which is part of all 3 services).

I suspect the amazing .mil career is rare these days (glad it worked out for me) and I'm pretty senior and things were probably different before 9/11.

I also occasionally see civilians getting screwed in "Army/Navy hpsp like ways" so there really aren't guarantees in medicine. The horrible .mil career is probably a little too common in the Army/Navy for me to ever recommend their respective hpsp programs but for those who get into the AF it's probably a little more viable than the frequent posters on this site would have you believe.

 

[pgg]

I won't deny it may be a better deal now. But even still it's a sore financial deal. And yes the bonuses matter for those in need. I have friends with 5 children and a wife whom once you divide his income is barely able to provide a decent life for kids and family. While for the work he does he should be making at least 3-4x what he is making now. I find the military has major problems with women and minorities. If your a single white male without children the military is a great life. I will say I have met some good people and lifelong friends. But overall it was a bad financial deal.

I can't speak to being female or a minority in the military, because I'm neither. My vague impression as a white guy is that it's no better or worse than the civilian world as a whole, maybe even better. At least civilians can quit, leave bad situations, and move to more civilized parts of the country. Civilians also have legal options AD military don't.

There's no excuse for getting medical special pays late. It's apathy and incompetence. Though I will say that my old moonlighting job paid me a month late for several consecutive months because the struggling hospital system was late in paying them their stipend. Unpredictable paydays, in terms of timing and dollar amount, aren't unknown in private practice partnership.

Every time I hear of military physicians who are (supposedly) unable to pay bills because the October bonus is late, I have to wonder why they're living month-to-month in the first place. It implies a certain lifestyle beyond their means the other 11 months of the year. Again, I'm not offering up any excuse or defense of the military for being late. It's inexcusable. But we're not 19 year old lance corporals with 18 year old wives and a 6 month old baby counting the days until that $900 paycheck.

Your friend with 5 kids and a wife knew what the military pay scale was when he signed up. Either he had the kids already or he chose to have them while on active duty, and either way he knew what his income was going to be. Am I supposed to feel sympathy for his perceived inability to provide a "decent life" now? I've got 3 kids and a stay-at-home wife. The first was born my first semester of medical school. Oldest kid in now in college, and two in a private high school with associated expensive extracurriculars (private music school for one, traveling gymnastics team for the other). We don't own a boat or any jet skis and we haven't ever taken a family vacation overseas, but we have a decent life, no debt, satisfying retirement accounts nonetheless. Our dogs eat eat premium dog food. Things were tighter when I was a resident, they were in elementary school, and I wasn't getting ASP or ISP ... but it worked out fine.

Maybe he needs to recalibrate what he spends with what he needs, and what he deserves with what he signed up for. If making 3-4x what he's getting now (which I will dispute is an unreasonable expectation for an civilian anesthesiologist vs a post-ADSO military anesthesiologist) was so important to his minimum deserved lifestyle, he should've taken student loans like 98% of people do and not joined the military.

I can understand a little buyer's remorse and regret for taking the HPSP/USUHS money all those years ago, but I can't muster any sympathy for a military doctor who thinks he's not getting paid enough to provide a decent life for his family.

 

[Gastrapathy]

AF docs are some of the least happy in my experience. "Landed an AF spot" lol lol

 

[pgg]

AF docs are some of the least happy in my experience. "Landed an AF spot" lol lol

People have this odd notion that the AF is "less military" than the Army or Navy. But I guess planes are neat, or something. Baffling.