Army Civilian med school vs. USU

[vet0202]

First, I want to thank you for taking the time to read through my post. I have read through many of the threads here and took those to tailor to my specific situation.

I have been driving myself crazy going back and forth since I heard back with acceptances and best for me to do at this point is to reach out and seek advice. USU turns this into a 15-year decision so I want to make the best-informed decision. Despite military’s flaws, quirks and uncertainties, I was 80% sure in committing to USU as it has been my first choice throughout this application cycle because my desire to serve trumped over its cons. My plan was to attend USU, serve my 7 years of obligation after residency then get out and work rest of my life in a civilian sector. I chose Army over Navy and Air Force because of more opportunities for GME and lack of GMO. However, just recently I came to learn about this deal breaker called Brigade Surgeon assignments with the Army. IF I end up in subspecialties, all those years of training could be ruined by serving in an administrative position for two years. If this assignment falls to me around last 2-3 years before my obligation is up, I would have no choice but to extend my ADSO, trying to CPR my career somehow. I have read that EM physician would be somewhat ok with the assignment because of the ability to moonlight at civilian hospitals to keep your skills but again this would be dependent upon your brigade commander. This would mean that I would need to be 100% in for EM which actually would be my top choice but I wanted to keep my specialty options open for ortho, surgery and others like IM (undermanned specialties to play the system) because I might change my mind as I journey through med school. I have also read that those specialties and especially EM is competitive in the military. While I believe that I could be competitive enough for EM, going to Rush and being trained at Cook County Hospital and working in a civilian trauma centers seems more attractive than military training and working in military ERs.

Currently one of my professors is a retired army FM physician (West point + HPSP route) who is still at Ft. Belvoir. He thinks that Army would be a great option. 7-year obligation he says is 7 years of a guaranteed job and I would get lots of attractive job offers coming out of the military. To those who served and was in a similar situation, what would you do in my position? Would you recommend me to go to USU or go to civilian med school? While I understand not two people will have the same experience with the military, I would appreciate the feedbacks.

Below is the some of the pros and cons of both institutions that I have written down.

USU/military Pros

• Financial flexibility (money spread throughout the years)
• Adventurous opportunities in school
• Moving to different places through military
• Great institution
• Taking step 1 in M3
• Can stay in DC, close to my SO at least for two years (Vet student in VTECH) and maybe beyond if she stays in East Coast

USU/ military Cons

• Brigade Surgeon Assignments-> I read that this could be career ending for subspecialties
• 7 years of obligation + IRR
• Limited number of specialties
• More competitions for EM residencies
• Skill atrophy
• Uncertainty after USU
• Needs of the army > your needs
• Always can join through FAP rather than through USU

Rush Pros

• Strong clinical exposure and clinical education esp with EM -> Cook County Hospital
• Flexibilities with residencies in terms of locations and specialties
• Career/life flexibilities
• Instant research opportunity with my friend who is currently M1 there

Rush Cons

• New “flipped classroom curriculum”
• Moving to Chicago and being further away from my SO
• Loans

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[WernickeDO]

First, I want to thank you for taking the time to read through my post. I have read through many of the threads here and took those to tailor to my specific situation.

I have been driving myself crazy going back and forth since I heard back with acceptances and best for me to do at this point is to reach out and seek advice. USU turns this into a 15-year decision so I want to make the best-informed decision. Despite military’s flaws, quirks and uncertainties, I was 80% sure in committing to USU as it has been my first choice throughout this application cycle because my desire to serve trumped over its cons. My plan was to attend USU, serve my 7 years of obligation after residency then get out and work rest of my life in a civilian sector. I chose Army over Navy and Air Force because of more opportunities for GME and lack of GMO. However, just recently I came to learn about this deal breaker called Brigade Surgeon assignments with the Army. IF I end up in subspecialties, all those years of training could be ruined by serving in an administrative position for two years. If this assignment falls to me around last 2-3 years before my obligation is up, I would have no choice but to extend my ADSO, trying to CPR my career somehow. I have read that EM physician would be somewhat ok with the assignment because of the ability to moonlight at civilian hospitals to keep your skills but again this would be dependent upon your brigade commander. This would mean that I would need to be 100% in for EM which actually would be my top choice but I wanted to keep my specialty options open for ortho, surgery and others like IM (undermanned specialties to play the system) because I might change my mind as I journey through med school. I have also read that those specialties and especially EM is competitive in the military. While I believe that I could be competitive enough for EM, going to Rush and being trained at Cook County Hospital and working in a civilian trauma centers seems more attractive than military training and working in military ERs.

Currently one of my professors is a retired army FM physician (West point + HPSP route) who is still at Ft. Belvoir. He thinks that Army would be a great option. 7-year obligation he says is 7 years of a guaranteed job and I would get lots of attractive job offers coming out of the military. To those who served and was in a similar situation, what would you do in my position? Would you recommend me to go to USU or go to civilian med school? While I understand not two people will have the same experience with the military, I would appreciate the feedbacks.

Below is the some of the pros and cons of both institutions that I have written down.

USU/military Pros

• Financial flexibility (money spread throughout the years)
• Adventurous opportunities in school
• Moving to different places through military
• Great institution
• Taking step 1 in M3
• Can stay in DC, close to my SO at least for two years (Vet student in VTECH) and maybe beyond if she stays in East Coast

USU/ military Cons

• Brigade Surgeon Assignments-> I read that this could be career ending for subspecialties
• 7 years of obligation + IRR
• Limited number of specialties
• More competitions for EM residencies
• Skill atrophy
• Uncertainty after USU
• Needs of the army > your needs
• Always can join through FAP rather than through USU

Rush Pros

• Strong clinical exposure and clinical education esp with EM -> Cook County Hospital
• Flexibilities with residencies in terms of locations and specialties
• Career/life flexibilities
• Instant research opportunity with my friend who is currently M1 there

Rush Cons

• New “flipped classroom curriculum”
• Moving to Chicago and being further away from my SO
• Loans

Not in the same position as your FM friend but I've been in for longer than a minute and I am going to weigh in anyway.

You have positioned yourself well and you are asking the right questions. You are correct to fear the Brigade Surgeon tour, and the Army will no hesitate to spring that on you when you are nearing the end of your commitment. This is done intentionally to get you to re-up, as the attrition rate for physicians is >85%. But along with this, consider the assignments which put you in the middle of nowhere with no patient volume or acuity. As a surgeon/CC specialist/subspecialist you will be hard pressed to find the numbers to stay sharp with your skills. This is a physician assignment per se, but it's not like being assigned to a MTF, or Cook County for that matter.

You have a desire to serve, which is critical. USUHS is an excellent school, and you will get good training in the Army. Getting paid as an O1 while your civilian counterparts are racking up debt that you can calculate by the minute is a boon. But you will sacrifice control over your career. Staying near to your SO is a draw to USUHS, but will your SO be psyched about moving to Ft Polk or Ft Irwin?

Some good advice that I read here on SDN regarding milmed was to assume that the Army is going to make every bad case scenario happen to you. So don't approach this as a hopefully you can avoid a GMO/Brigade Surgeon tour and get good assignments after training in the field you want. Approach this as getting denied the training in the specialty you want, and doing GMO tours at Ft Drum (you do realize that the Army has GMO tours right?). Would you still want to join at that point?

 

[WernickeDO]

Good questions and I'm med student now, but previous AD PA. From what I've seen, majority of BDE Surgeon billets go to FM, EM, and peds, sometimes IM. Operational medicine is a fantastic gig. More opportunities to train with the line guys, train medics, and take care of soldiers-that can be a negative aspect at times. If you like operational medicine, there are other opportunities in SOF and other units that take you closer to combat.

I have worked for several USU grads (FM and EM) and they are exceptional physicians. I've also worked down range with USU grads in surgical specialities, again, exceptional docs.

You can be very proactive with your career and have great satisfaction, but I have seen big Army tell a doc where he's going to work. He was not too happy.


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I'm not sure I would call operational medicine a fantastic gig. Most docs want to practice medicine, and seeing knee pain and shaving profiles is not medicine.

 

[Mace1370]

USUHS is a fantastic school that will give you a good education and the opportunity to serve the military. If you fell in love with the school like I did, then it will probably meet your expectations. However, remember that going to Rush doesn't prevent you from joining the military at a later date and will make you much more flexible in the long run.

Just my 2 cents, as a USUHS grad who loved his time there.

 

[DrMetal]

First, I want to thank you for taking the time to read through my post.

Don't mention it, it's our civic duty.

I chose Army over Navy and Air Force because of more opportunities for GME and lack of GMO.

Hope you like Texas

This would mean that I would need to be 100% in for EM which actually would be my top choice but I wanted to keep my specialty options open for ortho, surgery and others like IM (undermanned specialties to play the system)

That's a pretty broad brush. Be careful, your choice of specialty can (very much) determine your happiness in the .mil . EM docs and surgeons tend to be the least happy per low acuity and volume....primary care physicians tend to be the happiest per adequate acuity and volume....

If you're uncertain about what specialty you want to practice, I would almost advocate not joining the .mil right now. Come in at a later entry point.

[USUHS is a good school....that's not the issue. Whether you want to commit to the military for such a long time is the more pertinent issue.]

 

[j4pac]

The USUHS is just too long. Life changes much faster than you'd think. You want some flexibility in your life...and USUHS takes that away from you.

If you are 80% you want to serve but don't want to retire military...I'd look toward the other scholarship programs (HPSP, FAP, etc). That way you get a taste of the military but without near the commitment.

 

[Gastrapathy]

The USU commitment is not really any different than the surgical or subspecialty commitment.

I agree with don't join now but HPSP is really only better for GMO and out.

 

[Armyhealth]

Why not do HPSP which is a 4 year commitment and you usually get into the specialty you want your first tour (they most likely won't move you if your only doing four years.) Still eliminates the debt and gives you the civilian med school route but you get your chance for adventure and the unique opportunities you want. By the way I am a Army Healthcare Recruiter....figure I should mention that but private message me if you want to go into detail or I can get you in contact with a few EM docs.

 

[ArmyTiger]

Why not do HPSP which is a 4 year commitment and you usually get into the specialty you want your first tour (they most likely won't move you if your only doing four years.) Still eliminates the debt and gives you the civilian med school route but you get your chance for adventure and the unique opportunities you want. By the way I am a Army Healthcare Recruiter....figure I should mention that but private message me if you want to go into detail or I can get you in contact with a few EM docs.

As is pretty clearly stated above, you do not always get into your first choice specialty, especially for EM or general surgery or Ortho, among others. Then you're stuck with reapplying in a system that doesn't really like reapplicants, or waiting to get out and start your career. Easier to try to join with a board certification through FAP, especially for OP.

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[Armyhealth]

As is pretty clearly stated above, you do not always get into your first choice specialty, especially for EM or general surgery or Ortho, among others. Then you're stuck with reapplying in a system that doesn't really like reapplicants, or waiting to get out and start your career. Easier to try to join with a board certification through FAP, especially for OP.

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We had a 84% match rate into first choice last year and 95% top three....I would say that is not bad. As long as you do a rotation at the location you are trying to apply you usually have a very good chance to match in.

 

[ArmyTiger]

We had a 84% match rate into first choice last year and 95% top three....I would say that is not bad. As long as you do a rotation at the location you are trying to apply you usually have a very good chance to match in.

That is simply not true for all specialties. Read the thread. 1.7 applicants for each 1 spot in EM, just on the graduating MS4 side. Probably a few GMOs returning, too. And that's just EM. Gen surg, if i recall, was something over 2 applicants per spot. And this applicant wants to do EM. Almost half of those applicants end up unhappily settling for a less than ideal career, just by the numbers. If you do IM, sure, 100% match rate, probably to your top pick. But that's hardly everyone's experience.

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[Armyhealth]

That is simply not true for all specialties. Read the thread. 1.7 applicants for each 1 spot in EM, just on the graduating MS4 side. Probably a few GMOs returning, too. And that's just EM. Gen surg, if i recall, was something over 2 applicants per spot. And this applicant wants to do EM. Almost half of those applicants end up unhappily settling for a less than ideal career, just by the numbers. If you do IM, sure, 100% match rate, probably to your top pick. But that's hardly everyone's experience.

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That data is for one year (last year's class group). Looking at historical data it was 1.4 2 years ago and 1.1 three years ago. That just happened to be a year where that class group had a lot interested in EM. Doesn't mean it will be that way 4 years from now. Gen surg was 1.4 vs 1.5 for civilian so actually a better match rate. I can send you the numbers from the GME office if you want.

 

[DrMetal]

ArmyTiger is being more accurate and realistic here. ArmyHealth is an FOS recruiter (you can build historical data to show whatever you want)


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[WernickeDO]

That data is for one year (last year's class group). Looking at historical data it was 1.4 2 years ago and 1.1 three years ago. That just happened to be a year where that class group had a lot interested in EM. Doesn't mean it will be that way 4 years from now. Gen surg was 1.4 vs 1.5 for civilian so actually a better match rate. I can send you the numbers from the GME office if you want.

I assume you are getting the 1.5 civilian applicant v. match number from the most recent NRMP publication: http://www.nrmp.org/wp-content/uploads/2016/04/Main-Match-Results-and-Data-2016.pdf

You'll note that you only come up with 1.5 is look at "US seniors", which only describes graduating MS4s from MD schools. 25% of general surgery's match last year came from the nebulous "others", meaning DO grads, people who did other specialties and switched, and people who are returning to the match after a year or two away. IMG/FMG are in that number too. Conversely, milmed considers only MS4's in its published data. It does not take into account applying GMO's or people who have already completed a residency and are now picking up another specialty. The numbers clearly compare two different candidate pools.

Additionally, there are 27 PGY1 GS positions in the Army. There are over 1200 in the civilian world. To look at application number between the two and note that the decisions of 2 or 3 milmed MS4s can swing the numbers so dramatically does not equal a comparable sea change in the civilian world.

I assume that you are a NCO and probably a damn good one, but you are not qualified to talk to pre-meds about the adventures of being a military physician.

 

[Armyhealth]

I assume you are getting the 1.5 civilian applicant v. match number from the most recent NRMP publication: http://www.nrmp.org/wp-content/uploads/2016/04/Main-Match-Results-and-Data-2016.pdf

You'll note that you only come up with 1.5 is look at "US seniors", which only describes graduating MS4s from MD schools. 25% of general surgery's match last year came from the nebulous "others", meaning DO grads, people who did other specialties and switched, and people who are returning to the match after a year or two away. IMG/FMG are in that number too. Conversely, milmed considers only MS4's in its published data. It does not take into account applying GMO's or people who have already completed a residency and are now picking up another specialty. The numbers clearly compare two different candidate pools.

Additionally, there are 27 PGY1 GS positions in the Army. There are over 1200 in the civilian world. To look at application number between the two and note that the decisions of 2 or 3 milmed MS4s can swing the numbers so dramatically does not equal a comparable sea change in the civilian world.

I assume that you are a NCO and probably a damn good one, but you are not qualified to talk to pre-meds about the adventures of being a military physician.

You are correct and that is why I do not talk about the adventures of being a military physician. If I have those who are interested I put them in direct contact with a military physician. However I am a combat medic and have seen my fair share of Army medicine through three deployments and 15 years in the service. So to just push my experience out is a little harsh. Your right about the numbers, can't really compare Army match numbers to civilian numbers.

 

[Armyhealth]

ArmyTiger is being more accurate and realistic here. ArmyHealth is an FOS recruiter (you can build historical data to show whatever you want)


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FOS...first time I have ever been called that. Not trying to give anyone BS, just telling you the numbers that come directly from the Army's GME office.

 

[WernickeDO]

You are correct and that is why I do not talk about the adventures of being a military physician. If I have those who are interested I put them in direct contact with a military physician. However I am a combat medic and have seen my fair share of Army medicine through three deployments and 15 years in the service. So to just push my experience out is a little harsh. Your right about the numbers, can't really compare Army match numbers to civilian numbers.

You specifically told a pre-med that military medicine is an adventure. To call it that but then back away saying you don't talk about them doesn't make sense. I'm sure you have a stable of mil docs who are thrilled with the Army, but OP is already in touch with literally dozens of mil docs right here on this forum.

You gave a pre-med false statistics in an effort to recruit them. I'm sure it was out of ignorance rather than malice, but you had better get your facts straight before posting on this forum. I know you are quoting GME numbers but passing the buck doesn't work here. You are accountable for the things you claim.

No one is discounting your experience as a combat medic. In fact I assume that you are an excellent NCO, because I know that only the best become recruiters. I said as much in my post. But your experience as a medic does not equate with being a military physician. Sorry. And "being around" milmed does not excuse giving pre-meds bad information as a fact.

Understand too that every year a recruiter comes on this forum and tries to recruit. You are certainly welcome to do so but give the pre-meds good information. Acknowledge the pros and cons of milmed and help them to make a (somewhat) informed decision.

 

[Armyhealth]

You specifically told a pre-med that military medicine is an adventure. To call it that but then back away saying you don't talk about them doesn't make sense. I'm sure you have a stable of mil docs who are thrilled with the Army, but OP is already in touch with literally dozens of mil docs right here on this forum.

You gave a pre-med false statistics in an effort to recruit them. I'm sure it was out of ignorance rather than malice, but you had better get your facts straight before posting on this forum. I know you are quoting GME numbers but passing the buck doesn't work here. You are accountable for the things you claim.

No one is discounting your experience as a combat medic. In fact I assume that you are an excellent NCO, because I know that only the best become recruiters. I said as much in my post. But your experience as a medic does not equate with being a military physician. Sorry. And "being around" milmed does not excuse giving pre-meds bad information as a fact.

Understand too that every year a recruiter comes on this forum and tries to recruit. You are certainly welcome to do so but give the pre-meds good information. Acknowledge the pros and cons of milmed and help them to make a (somewhat) informed decision.

Actually I said in military medicine you would have a "chance" at adventure, for instance signing up for airborne school. That would qualify for adventure, correct? Your goal to say exactly the opposite of whatever I say and discredit me is a little overboard. Just because whatever your role in the military or not in the military is not what you expected it is not the same for everyone else. I know plenty of physicians who have been in 20+ years and love what they do. My job is to put in physicians who want to serve their country and serve Soldiers who deserve great health care. You go ahead and be that guy who comes on here and tries to use your wit and intellect to scare recruiters away and steer others away but let them make their own choice.

 

[vet0202]

Wow, I appreciate all the feedbacks!

WenickeDO, thank you for the advice. Because I am so drawn to USU, every scenario that I run it in my head is with the hopes that I can somehow maneuver through military and have everything go the way that I have planned out. Even now, I have this glimmer of hope that maybe just maybe it can happen just like the Patriots coming back from 28-3. I am being way too naïve. I will approach this decision with the thought “what is the worst that can happen”. Also, my SO will have her professional career as a veterinarian and it would not be fair to her to just follow me for the duration of my .mil career. Yes, I do understand Army has GMO tours but I am fairly confident that I can match into my first choice if not I would not mind going into IM then fellowship.

Dr. Metal and j4pac, you hit the issue right on. It’s the issues after USU that I am worried about and holding me back.

Also, it seems like we are getting sidetracked a bit with HPSP…

Armyhealth, the reason why I did not mention HPSP was that I am 100% not doing HPSP. No matter what residency I end up in, I am following up with a fellowship whether that’s in civ med school or USU so HPSP will just end up adding up ADSO to a point that USU is a lot better choice like Gastrapathy has commented. I appreciate the input but I wanted to hear more from the docs in this community what they would do if they are in my position, now that they had gained all this experience.

Here are some additional questions that I have now if you guys don’t mind answering.

1. Is there a statistic for what percentage of the army docs are serving in the Brigade Surgeon tour?
   
   
2. If the whole military match data is skewed in a way that it only shows the numbers of applicants with only graduating MS4, is there a true military match data that includes all the applicants that people can access? If not, what would be some realistic numbers? Would that 1.7 applicants number jump up to 2.7 applicants?
   
   
3. For the docs that are saying do not join, what are some of the issues and experiences that you personally faced that makes you discourage others from joining? I would like to hear about your stories so I can paint a bigger picture of what could happen.
   
   
4. Also, do most of your colleagues (mainly the ones that are not on the forum) feel the same way as you do?

 

[SirGecko]

If you are thinking you for sure want to do a fellowship just be aware that most people don't go straight from residency to fellowship in the military. You could potentially have as big a gap between residency and fellowship staying in the military as you would if you did hpsp and out. (If they even let you go do a fellowship) So hpsp may not actually be worse than USU at that point. Kind of depends on what your priorities are.

If you won't be happy unless you do "x" fellowship the military as its currently set up may not be what you want long term. Remember the number one thing you are usually sacrificing in mil med is the power of self determination.

 

[WernickeDO]

Actually I said in military medicine you would have a "chance" at adventure, for instance signing up for airborne school. That would qualify for adventure, correct? Your goal to say exactly the opposite of whatever I say and discredit me is a little overboard. Just because whatever your role in the military or not in the military is not what you expected it is not the same for everyone else. I know plenty of physicians who have been in 20+ years and love what they do. My job is to put in physicians who want to serve their country and serve Soldiers who deserve great health care. You go ahead and be that guy who comes on here and tries to use your wit and intellect to scare recruiters away and steer others away but let them make their own choice.

Airborne school is a great 3 week adventure. Is that worth an 8 year commitment? And you only get to go if attached to an Airborne unit, which the majority of docs will not be.

I have no goals to oppose you, just prevent you from telling pre-meds incorrect things. You seem utterly unrepentant about the misinformation you gave before and I truly hope that you stop. If you want to get docs in who want to serve their country, then have enough decency to tell them the truth. Don't be upset if people have had bad experiences and share them here when pre-meds ask questions. They ARE making their own decisions, and the information on this forum is the best source of information on milmed out there. The fact that you don't like information that conflicts with your recruiting mission suggests that you don't care about the docs you recruit, just your numbers.

Wit and intellect? You flatter me.

I think that you will continue to take whatever I say as a personal attack so I think I will withdraw. Good luck.

 

[WernickeDO]

Wow, I appreciate all the feedbacks!

WenickeDO, thank you for the advice. Because I am so drawn to USU, every scenario that I run it in my head is with the hopes that I can somehow maneuver through military and have everything go the way that I have planned out. Even now, I have this glimmer of hope that maybe just maybe it can happen just like the Patriots coming back from 28-3. I am being way too naïve. I will approach this decision with the thought “what is the worst that can happen”. Also, my SO will have her professional career as a veterinarian and it would not be fair to her to just follow me for the duration of my .mil career. Yes, I do understand Army has GMO tours but I am fairly confident that I can match into my first choice if not I would not mind going into IM then fellowship.

Dr. Metal and j4pac, you hit the issue right on. It’s the issues after USU that I am worried about and holding me back.

Also, it seems like we are getting sidetracked a bit with HPSP…

Armyhealth, the reason why I did not mention HPSP was that I am 100% not doing HPSP. No matter what residency I end up in, I am following up with a fellowship whether that’s in civ med school or USU so HPSP will just end up adding up ADSO to a point that USU is a lot better choice like Gastrapathy has commented. I appreciate the input but I wanted to hear more from the docs in this community what they would do if they are in my position, now that they had gained all this experience.

Here are some additional questions that I have now if you guys don’t mind answering.

1. Is there a statistic for what percentage of the army docs are serving in the Brigade Surgeon tour?
   
   
2. If the whole military match data is skewed in a way that it only shows the numbers of applicants with only graduating MS4, is there a true military match data that includes all the applicants that people can access? If not, what would be some realistic numbers? Would that 1.7 applicants number jump up to 2.7 applicants?
   
   
3. For the docs that are saying do not join, what are some of the issues and experiences that you personally faced that makes you discourage others from joining? I would like to hear about your stories so I can paint a bigger picture of what could happen.
   
   
4. Also, do most of your colleagues (mainly the ones that are not on the forum) feel the same way as you do?

The Patriots comeback is something that can only be performed by the greatest coach of all time with the greatest QB of all time. It's something that we can all aspire to but we must temper our expectations.

GMO tours are the first of your worries. The vast majority of mil docs will not do a GMO tour (in the Army at least), but when it happens to you it's 100%.

Something else to consider is the patient acuity and volume that you will experience as an attending. I should have been a little more clear with with what I replied with before, but there is always a chance that you get stationed in some backwater, bored out of your mind with no patients to see. Ft Polk/Irwin are home to training grounds, which means you have battalions rotating through and you will be treating the sprained ankles and smashed hands that comes with it. By and large, the military is a young, healthy population. If your goal is to take care of sick people, then mil is not the best place for it. I know it probably doesn't sound too bad now but by the end of MS4 your goal will be to practice medicine.

A shot at your questions:

1: Don't know about a statistic. It is true that the people tabbed are usually FM, IM, EM, but I personally know neonatologists, anesthesiologists, and surgeons doing brigade tours. Some volunteered, some were forced into it. As long as you are in the military that will be a possibility.

2: The Army does not publish the match data outside of MS4 applicants. I can tell you that the 2015 EM match for non-MS4s was 28 applicants for 6 spots. Some spots went directly to Air Force applicants. Take a look at the Pros and Cons sticky for more on this. GMOs are in a different pool from MS4s, and the available slots will go first to the MS4s. Anything left over is a potential for a GMO, but programs have also gone unfilled rather than take GMOs (derm last year being an example).

3: spend some time reading through this forum and try to glean from the experiences that the mil docs have had. Most of the complaints you will find has to do with patient volume/acuity, military redtape and BS, getting stationed in the middle of nowhere, and not getting the training they want. Money is usually not a deciding issue for people.

4: Some love the mil, some don't.

 

[pgg]

We had a 84% match rate into first choice last year and 95% top three....I would say that is not bad. As long as you do a rotation at the location you are trying to apply you usually have a very good chance to match in.

That is a really, really wrong way to interpret that data. You do not (not!!!) have an 84% chance of getting whatever you want just by applying and getting some face time via an away rotation. I suspect, when I phrase it this way, you're thinking "of course I know that" but that nuance is lost when you just say "84% match rate into first choice" and people get misled.

You can't interpret these published match rates as probabilities of getting what you want. A match rate, taken in isolation of other factors, is not a probability - and with regard to the military match, there are a lot of those "other factors" ...

The biggest issue is that people self-select themselves out of applying to programs they realize their grades & board scores aren't competitive for, and thus their "first choice" given their options and odds within the constraints of the military GME system might not really be their first choice. Of course self-selection happens in the civilian match too, but there are some fundamental differences between the civilian match and the military match that magnify this effect in the military. This is an especially important point to appreciate because the military match
1) is very very small (the tyranny of small numbers is a real thing and that tyrant is never on your side)
2) has extraordinary year-to-year variability in a given specialty's applicant:slot ratio
3) may or may not have any positions in a particular specialty some years (or ever)
4) has consistently skewed levels of competitiveness compared to the civilian match for some specialties (the classic example we give is that EM is more competitive in the military than it is in the civilian match)

Check out NRMP's "charting outcomes" documents. The N is high, and "match probabilities" are broken out by specialty, applicant board scores, number of programs ranked, etc. This is good data. To the best of my knowledge, the JSGMESB has never released this kind of data, which makes it really hard to give honest and complete answers to premeds who ask what GME match odds are.

Not subject to misinterpretation: "1,045 out of 1,063 (98%) of US grad family medicine applicants with a USMLE Step 1 score above 200 matched into a FM residency program somewhere"

Ambiguous: "84% match into first choice"

See what I mean?

 

[pgg]

USU has a condensed 18 month preclinical curriculum followed by a clinical education that consists of jumping state to state every few months. As someone with a family, this is less than ideal. For a single person, this could probably be seen as a pro for the school.

To be fair, this isn't a lot different than many of the DO schools that don't have affiliated teaching hospitals. Ask Touro grads how much time they spent jumping around from place to place to get their clinicals done ...

USU has Walter Reed. When I was a student there, the people who wanted to stay local for clinicals were largely able to trade with people who wanted to travel. I remember a family man who gladly gave me his 6 week peds rotation at Tripler in return for mine at Bethesda. That gave me a 12 week block in Hawaii ... dragged my wife and two (small at the time) kids out there and we scammed a 2-bedroom townhouse at Hickam base housing for $17/night. It was awesome.

 

[Atlas Shrugged]

USU has a condensed 18 month preclinical curriculum followed by a clinical education that consists of jumping state to state every few months. As someone with a family, this is less than ideal. For a single person, this could probably be seen as a pro for the school.

Definitely a pro for single people. And as pgg said, those who wanted to stay in Bethesda were almost certainly able to via trading. 12 weeks at Tripler here as well, and it was wonderful.

 

[Armyhealth]

That is a really, really wrong way to interpret that data. You do not (not!!!) have an 84% chance of getting whatever you want just by applying and getting some face time via an away rotation. I suspect, when I phrase it this way, you're thinking "of course I know that" but that nuance is lost when you just say "84% match rate into first choice" and people get misled.

You can't interpret these published match rates as probabilities of getting what you want. A match rate, taken in isolation of other factors, is not a probability - and with regard to the military match, there are a lot of those "other factors" ...

The biggest issue is that people self-select themselves out of applying to programs they realize their grades & board scores aren't competitive for, and thus their "first choice" given their options and odds within the constraints of the military GME system might not really be their first choice. Of course self-selection happens in the civilian match too, but there are some fundamental differences between the civilian match and the military match that magnify this effect in the military. This is an especially important point to appreciate because the military match
1) is very very small (the tyranny of small numbers is a real thing and that tyrant is never on your side)
2) has extraordinary year-to-year variability in a given specialty's applicant:slot ratio
3) may or may not have any positions in a particular specialty some years (or ever)
4) has consistently skewed levels of competitiveness compared to the civilian match for some specialties (the classic example we give is that EM is more competitive in the military than it is in the civilian match)

Check out NRMP's "charting outcomes" documents. The N is high, and "match probabilities" are broken out by specialty, applicant board scores, number of programs ranked, etc. This is good data. To the best of my knowledge, the JSGMESB has never released this kind of data, which makes it really hard to give honest and complete answers to premeds who ask what GME match odds are.

Not subject to misinterpretation: "1,045 out of 1,063 (98%) of US grad family medicine applicants with a USMLE Step 1 score above 200 matched into a FM residency program somewhere"

Ambiguous: "84% match into first choice"

See what I mean?

Ok....let me rephrase. We had a 84% first choice match rate for what was applied for.....how are we supposed to do the math for something someone does not apply for. You can discredit the numbers...but the math is the math.

 

[Helpful Troll]

Ok....let me rephrase. We had a 84% first choice match rate for what was applied for.....how are we supposed to do the math for something someone does not apply for. You can discredit the numbers...but the math is the math.

Armyhealth - For clarity - The 84% first choice match rate is for MS4 applicants only and across all specialties? 2015 graduates is the year of analysis used identifying 84% match rate?

 

[Gastrapathy]

No the math is not the math.

Does the math account for GMOs or only MS4 applicants?
Does the math vary significantly year to year (see tyranny of small numbers since I suspect that went over your head)?
Is the FACT that certain specialties are completely unavailable in an unpredictable fashion shown by the math?
Does the math reflect whether people get to practice the specialty after training in it?
What does the math say about the Army's plan for future training of pediatric subspecialties (for example) 8 years from now when your current victims actually get to the point where they can apply?
What happens if you don't match?

You're drawing false conclusions to help sell a used car. When you've rolled back the odometer, it's not just about the number

 

[Gastrapathy]

Why not do HPSP which is a 4 year commitment and you usually get into the specialty you want your first tour (they most likely won't move you if your only doing four years.) Still eliminates the debt and gives you the civilian med school route but you get your chance for adventure and the unique opportunities you want. By the way I am a Army Healthcare Recruiter....figure I should mention that but private message me if you want to go into detail or I can get you in contact with a few EM docs.

What are your incentives for meeting your recruitment goals? If a student chooses USU over HPSP, do you get credit for that student?

 

[Perrotfish]

.....how are we supposed to do the math for something someone does not apply for.

The way that you would show the competitiveness of the military match compared to the civilian match is to publish the average step one score and class rank of a matched applicant. If you need a much higher score to match in the Army than in the civilian world then being trapped in the Army obviously puts you at a big disadvantage for that specialty. The high 'first choice' match rate really just reflects the fact that medical students are smart enough not to apply for a specialty they're not going to get.

The military very deliberately does not publish their match data, which is frustrating for anyone trying to counsel applicants. However you can get an average of at least the last several years by coming to a board like this and talking to experienced physicians, because its a small community and we all know what the new Intern class stats are for our specialties. And the numbers required to get military specialties is almost always higher. For some specialties, like EM, the difference between the civilian and military competitiveness is ridiculous. The Step 1 score required to get a Navy EM program is usually 20 points higher than the national average, and 40 points higher than the average for the low tier programs that borderline applicants otherwise would have had access to. There are a lot of family doctors in the military who probably would have been ER docs if they had stayed civilian.

 

[pgg]

Ok....let me rephrase. We had a 84% first choice match rate for what was applied for.....how are we supposed to do the math for something someone does not apply for. You can discredit the numbers...but the math is the math.

You know, I'm being polite, trying to help you understand. I've had a pretty good run in the Navy, and I'm by no means anti-recruitment or anti-recruiter. I want strong candidates to join because I'll be teaching them, then working with them, and then someday getting cared for by them.

But you clearly don't get why that number is misleading, and when you ask "how are we supposed to do the math" right after I point you at the NRMP documents that actually do that math for the civilian match ... c'mon, man, read my post again.


"It is difficult to get a man to understand something, when his salary depends on his not understanding it."

Stop trying so hard to prove Upton Sinclair right.

 

[Cooperd0g]

We had a 84% match rate into first choice last year and 95% top three....

The main problem with this statement is that people are trying to select what they will do for the rest of their career and they are ALREADY committed to the military at this point. Even if the numbers didn't have a lot of the caveats that other pointed out, it isn't good enough.

 

[Armyhealth]

What are your incentives for meeting your recruitment goals? If a student chooses USU over HPSP, do you get credit for that student?

We have no incentives for anyone we "recruit". We have a mission which is given to us each year and we attempt to put that in. For instance I am on for 2 HPSP medical, 1 HPSP dental and three HPSP veterinarian. I have met Dr. Saguil in person and we are all on the same team, it does not matter to me if someone chooses HPSP vs USUHS. I just want to help those who want to serve, I am only a recruiter for three years and then I go back to being a combat medic where I will end up working for some people you I "recruited" so I am not here to mislead anyone.

 

[Armyhealth]

The way that you would show the competitiveness of the military match compared to the civilian match is to publish the average step one score and class rank of a matched applicant. If you need a much higher score to match in the Army than in the civilian world then being trapped in the Army obviously puts you at a big disadvantage for that specialty. The high 'first choice' match rate really just reflects the fact that medical students are smart enough not to apply for a specialty they're not going to get.

The military very deliberately does not publish their match data, which is frustrating for anyone trying to counsel applicants. However you can get an average of at least the last several years by coming to a board like this and talking to experienced physicians, because its a small community and we all know what the new Intern class stats are for our specialties. And the numbers required to get military specialties is almost always higher. For some specialties, like EM, the difference between the civilian and military competitiveness is ridiculous. The Step 1 score required to get a Navy EM program is usually 20 points higher than the national average, and 40 points higher than the average for the low tier programs that borderline applicants otherwise would have had access to. There are a lot of family doctors in the military who probably would have been ER docs if they had stayed civilian.

That actually makes a lot of sense, thanks for breaking it down. It is something I will bring up when we have our meetings with our GME coordinators. I am just one healthcare recruiter but if I can put that idea up maybe we can get some more realistic numbers to post.

 

[Armyhealth]

You know, I'm being polite, trying to help you understand. I've had a pretty good run in the Navy, and I'm by no means anti-recruitment or anti-recruiter. I want strong candidates to join because I'll be teaching them, then working with them, and then someday getting cared for by them.

But you clearly don't get why that number is misleading, and when you ask "how are we supposed to do the math" right after I point you at the NRMP documents that actually do that math for the civilian match ... c'mon, man, read my post again.


"It is difficult to get a man to understand something, when his salary depends on his not understanding it."

Stop trying so hard to prove Upton Sinclair right.

My salary does not change if I put 1000 people in or 1 person in. I do understand what your saying, however as a Navy Physician you have to understand that we are mandated to put out information based on what is published. If I go around saying info that does not match up with what our GME department is putting out then I have a great shot at being investigated.

 

[Gastrapathy]

^^read this. Policy trumps truth. Make sure that sinks in.

 

[Gastrapathy]

You can't tell anyone whether we will even train their desired specialty in 4 years. What percentage is 0:0?

 

[Perrotfish]

You can't tell anyone whether we will even train their desired specialty in 4 years. What percentage is 0:0?

I don't think its reasonable to blame recruiters for not warning every applicant that the future is uncertain, that's just a universal problem. There were lots of civilians who went into my class thinking they were going to do ED who saw the specialty's average step one rise out of range, or who thought they were going into path but who saw the job market collapse. The best you can reasonably expect as an applicant to military or civilian medicine is to have an accurate picture of the match and job market the year you sign up.

 

[Gastrapathy]

The civilian market changes slowly. The .mil with a stroke of a pen. It is different. Take the IM subs as an example. One year we train 4 GIs, the next year 1. If your timing (luck) is bad, you are hosed. It's much more arbitrary and unpredictable. So if recruiter bob wants to quote match rates, he has to own the whole match process.

Why don't you tell us about peds subs and how that compares to the real world.

 

[pgg]

My salary does not change if I put 1000 people in or 1 person in. I do understand what your saying, however as a Navy Physician you have to understand that we are mandated to put out information based on what is published. If I go around saying info that does not match up with what our GME department is putting out then I have a great shot at being investigated.

You can give them the data Army GME gives you. Just don't try to convince them that it means something it doesn't.

Sell them on service to country, the unique things military physicians can do, places they can go, the potentially massive debt they'll avoid. All those things are unequivocally true.

 

[Mace1370]

The civilian market changes slowly. The .mil with a stroke of a pen. It is different. Take the IM subs as an example. One year we train 4 GIs, the next year 1. If your timing (luck) is bad, you are hosed. It's much more arbitrary and unpredictable. So if recruiter bob wants to quote match rates, he has to own the whole match process.

Why don't you tell us about peds subs and how that compares to the real world.

Gastrapathy, I agree with 99% of what you are saying, but I don't think it is fair to say that the civilian side always changes slowly. For example, CMS can come out and slash reimbursements for several lucrative codes and totally upend what fellowships are the big money makers for a given field. Granted, this is no where near the level of change that can suddenly happen in military medicine with match rates, etc., but I think it can happen fast enough to affect people going through the training pipeline who have already made plans.

 

[Gastrapathy]

Agreed but its jut a matter of degree and frequency.

 

[AirborneBearcat]

USU has a condensed 18 month preclinical curriculum followed by a clinical education that consists of jumping state to state every few months. As someone with a family, this is less than ideal. For a single person, this could probably be seen as a pro for the school.

Current 3rd year USUHS student here - I can attest that the away rotations are both a great experience and a hardship on a family. I'm married, but with no children. I would have preferred to have done as many rotations as possible near my apartment and wife, but that's just not the way it worked out. I ended up doing 6 months of rotations local and 6 months at 3 different bases across the country (Jacksonville, FL, Ft. Bragg, NC, and Ft. Lewis/JBLM, WA). I probably learned more on those away rotations to be honest, since I was away from the "distractions" of real life. I lived in a hotel room, felt pretty isolated from any friends or family, so just ended up studying nearly non-stop. Even had time to get a publication. Travel and lodging was completely paid for as an MS3 (almost no funding for MS4 year though - all out of pocket), but at the same time being away for 6 months from your family might as well just be a short deployment.

I'm pretty early on in my medical career, but I knew what I was getting into when I signed up for USUHS (prior service enlisted as infantryman in the National Guard and then commissioned through ROTC). If you want to be an military doc, there is no better place to train than USUHS. If I could do it all over again, I would in a heartbeat. I'm not rich by any means, and my wife and I live in a pretty crappy 2 bedroom apartment (that still costs $1900/mo), but finances are not something I've really had to worry about in medical school while being paid as a full O-1 with over $3k/mo in base pay and $2200/mo in BAH (with dependents). I've done rotations with civilian students (both HPSP and non-schoarship) and they are under immense financial pressure and (at least on the surface) appeared much more miserable than myself or my classmates.

 

[champ94]

As someone who made the same decision (USUHS vs HPSP) about 10 months ago, I understand your thinking and agree with many of the posts above. I ended up choosing the HPSP route and am an MS1 at a medium-sized civilian school (and loving it!). A lot of people make decisions on the student programs based upon what happens after you get your MD. This is obviously very important, but it's had to know what you'll really want 4 years down the road. Thus, I would suggest that you consider the amount of military involvement during med school should as one of your focus points in making this decision.

For an HPSPer, I'm pretty gung-ho about mil med and, in my case, the Navy. And, because I have a lot of friends who are active duty officers on different career tracks across the branches, I am often envious of the amount of military stuff they have going on. Instead of reiterating the above points (which are certainly valid), I'll tell you about how, in the first year of med school, the difference between USUHS and HPSP is apparent to me.

1) Camaraderie—my med school class is great and tight-knit. For the most part I'm friendly with everyone and we all get along—I will come out with some lifelong friends. But I don't share many of the same concerns and passions my classmates have, as I'm focused on my military career ahead. In my understanding, USUHS offers an environment that is equally as tight-knit, but consists of students largely driven by their interest in a future in military medicine.

2) PT—many people believe time management is the key to success in medical school. This is certainly true. One of the biggest challenges as an HPSP student is making time, in the craziness of med school, to be as physically active as I need to be. A hugely important aspect of life at USUHS is that PT is programmed in your school days (others may correct me if I'm wrong) and I'm assuming it's a lot easier to maintain physical fitness.

3) Operational clerkships & field training—I happen to be particularly interested in working in operational medicine of some sort (FS, GMO, UMO, etc) following internship. In HPSP (in the Navy, at least) there are some opportunities for clinical rotations with an operational or operational-research focus. USUHS seems to have a lot more of these opportunities (for example, they're working on USUHS student shipboard medical rotations on LHDs). Also, I've heard that the programmed field experiences (i.e. operation bushmaster) are awesome.

4) Relationship to/involvement in your branch—if you wanted to, as an HPSP student, you can get away with minimal "military stuff" (i.e. ADTs, officer training, etc). If, during medical school, you don't like the idea of Uncle Sam knocking on your door frequently (i.e. 1-2 emails per month), perhaps HPSP is for you. However, the trade-off with this is that you're a lot less connected to resources unique to military med students (admin, detailing, scheduling, networking). USUHS has a distinct connection to the DC area's national medical/scientific healthcare industry, and the ability to build strong relationships there likely provides a distinct advantage.

A lot of speculation here as I've obviously never been a USUHS student, but It'd be wise to consider these things in addition to the above posts. Truly, I don't think you can go wrong with either choice—there are obvious trade offs to both options.

Hope this helps!

 

[pgg]

The "military-ness" of the USUHS experience is vastly overstated.

Aside from wearing a uniform every day, it'd be pretty easy to pretend you're not in the military at all for 363 days out of the year. There's no group PT or any time carved out of the schedule for that.

It's a medical school with uniforms, a fitness test twice per year, and a couple ankle-biter classes on military-isms.

 

[SirGecko]

PT—many people believe time management is the key to success in medical school. This is certainly true. One of the biggest challenges as an HPSP student is making time, in the craziness of med school, to be as physically active as I need to be. A hugely important aspect of life at USUHS is that PT is programmed in your school days (others may correct me if I'm wrong) and I'm assuming it's a lot easier to maintain physical fitness.

Unless something has drastically changed in the years since I was there USUHS does not have any special amount of time carved out for PT. Really your schedule is very similar to any other medical school. You have the time for PT that you carve out yourself. If it is important to you then it is simply something you have to budget some time for. Maybe the culture of the school values physical fitness more than some other medical schools but it is definitely still the individual's responsibility. (and no real reason to think this would be easier or harder to maintain at any other medical school)

 

[champ94]

The "military-ness" of the USUHS experience is vastly overstated.

Aside from wearing a uniform every day, it'd be pretty easy to pretend you're not in the military at all for 363 days out of the year. There's no group PT or any time carved out of the schedule for that.

It's a medical school with uniforms, a fitness test twice per year, and a couple ankle-biter classes on military-isms.

Unless something has drastically changed in the years since I was there USUHS does not have any special amount of time carved out for PT. Really your schedule is very similar to any other medical school. You have the time for PT that you carve out yourself. If it is important to you then it is simply something you have to budget some time for. Maybe the culture of the school values physical fitness more than some other medical schools but it is definitely still the individual's responsibility. (and no real reason to think this would be easier or harder to maintain at any other medical school)

I stand corrected. Thanks!

 

[vet0202]

Thank you to everyone that replied to my questions.
I recently made my decision and I figured I owe you guys at least that.
I withdrew my acceptance at USU. For these past four months, I have been going back and forth. Went to both school's second look day as well to make sure.

As I have stated before, EM would be my first choice. With all these talks about the military match, I knew I had to do more research before I made my decision. I was able to obtain the USU match list and only 2 people matched into EM (just for the army) this year which made my decision pretty clear.

 

[Homunculus]

Thank you to everyone that replied to my questions.
I recently made my decision and I figured I owe you guys at least that.
I withdrew my acceptance at USU. For these past four months, I have been going back and forth. Went to both school's second look day as well to make sure.

As I have stated before, EM would be my first choice. With all these talks about the military match, I knew I had to do more research before I made my decision. I was able to obtain the USU match list and only 2 people matched into EM (just for the army) this year which made my decision pretty clear.

i think in time you will be thankful you made the decision you did. you either owe a bank money or owe the army years of your life. the value of each is different for different people. if you have doubts and are set on a particular career path, the best way to optimize your chances of succeeding and maintain control is to avoid usuhs/hpsp. if you don't mind the potential detours and are really debt averse it can be a good option. you can always join later should you desire-- EM docs will always be in demand since so many of them leave.

good luck and stick around the forum -- your experience is probably shared with other people and you can keep tabs on how things are if you ever consider joining.

--your friendly neighborhood resisting the urge to say "another angel gets it's wings" caveman

 

[True Believer]

As I have stated before, EM would be my first choice. With all these talks about the military match, I knew I had to do more research before I made my decision. I was able to obtain the USU match list and only 2 people matched into EM (just for the army) this year which made my decision pretty clear.

I think you weighed the decision carefully and have good reasons for making it in favor of Rush, but to shed some more light, there were only 2 Army EM applicants from USU this year, both of whom matched into EM. To echo what was said above, USU has no structured fitness program aside from your service's PT test requirements (twice a year for the Army).