Compensation Clarification

[UCSFdreamin]

From reading throughout these forums, it seems that all but Family Practice take a significant pay cut by serving as a physician in the military.

However, I ran some numbers and this does not seem to be the case for emergency medicine with the FAP in residency. I'm assuming that I have misunderstood something, and would appreciate some clarification. I suppose the first question is whether FAP precludes all of the MSP, ISP bonuses one would get post-residency. But, moving on...

Imagine we start FAP at the first year of EM residency. We choose a 3-year EM residency, so you have a 4-year payback. Compensation breakdown is as follows.

During Residency:
FAP is 70,000k (45k annual +2k monthly) per year for three years of residency. [Is this on top of regular resident salary of ~$50,000??)

After Residency:
Variable Special Pay- 416.66 / month = $5,000/year
Board Certified Pay- 208 / month = $2,500/year
Incentive Special Pay- $30,000/year
Additional Special Pay- $15,000/year
Multiyear Special Pay- $40,000/year
Critical Wartime Skills- 276,000 one-time bonus = $69,000/year
Early Career Incentive Special Pay - $44,000 one-time bonus = $11,000/year
O-4 Officer Salary - average($51.5+51.5+59.6+63.5)*1000 = $56,000/year

Post residency, this comes out to an average of 5+2.5+30+15+40+69+11+56 = $228,000 per year.

That doesn't seem extremely far off from the average EM doc's salary, which I estimate to average at $260,000 from various web-reported surveys. If FAP isn't mutually exclusive with all those special pays, then the extra $20,000 per year ($70,000 per year if the FAP is a marginal salary on top of normal resident salary) seems to make this an extremely beneficial position.

So, what am I missing?

Thanks in advance for your insight and feedback.

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[Droopy Snoopy]

From reading throughout these forums, it seems that all but Family Practice take a significant pay cut by serving as a physician in the military.

However, I ran some numbers and this does not seem to be the case for emergency medicine with the FAP in residency. I'm assuming that I have misunderstood something, and would appreciate some clarification. I suppose the first question is whether FAP precludes all of the MSP, ISP bonuses one would get post-residency. But, moving on...

Imagine we start FAP at the first year of EM residency. We choose a 3-year EM residency, so you have a 4-year payback. Compensation breakdown is as follows.

During Residency:
FAP is 70,000k (45k annual +2k monthly) per year for three years of residency. [Is this on top of regular resident salary of ~$50,000??)

After Residency:
Variable Special Pay- 416.66 / month = $5,000/year
Board Certified Pay- 208 / month = $2,500/year
Incentive Special Pay- $30,000/year
Additional Special Pay- $15,000/year
Multiyear Special Pay- $40,000/year
Critical Wartime Skills- 276,000 one-time bonus = $69,000/year
Early Career Incentive Special Pay - $44,000 one-time bonus = $11,000/year
O-4 Officer Salary - average($51.5+51.5+59.6+63.5)*1000 = $56,000/year

Post residency, this comes out to an average of 5+2.5+30+15+40+69+11+56 = $228,000 per year.

That doesn't seem extremely far off from the average EM doc's salary, which I estimate to average at $260,000 from various web-reported surveys. If FAP isn't mutually exclusive with all those special pays, then the extra $20,000 per year ($70,000 per year if the FAP is a marginal salary on top of normal resident salary) seems to make this an extremely beneficial position.

So, what am I missing?

Thanks in advance for your insight and feedback.

You don't get MSP until after your obligation is up, and you don't get ECISP until I think your last year of obligation (both are geared toward retention). Also pretty sure you would enter as a Capt.

 

[haujun]

You don't get MSP until after your obligation is up, and you don't get ECISP until I think your last year of obligation (both are geared toward retention). Also pretty sure you would enter as a Capt.

I did not see anyone getting ECISP in the Army.

 

[colbgw02]

I did not see anyone getting ECISP in the Army.

Yeah, that would be news to me. Also, is anybody really getting a Critical Wartime bonus? I've never heard of that either.

Agree that you would not enter as an O-4. Even if all years in FAP count toward rank (I don't know enough about FAP to know either way) and you have no prior service, you'd be at O-3 over 3. Assuming a four year payback, you'd only be a major for your last year in.

MSP for EM is $26,000 by my pay table. Not sure where the 30K number is coming from.

Also, my understanding of emergency medicine board certification is that it doesn't happen - at the earliest - until the spring of your first year post-residency.

The numbers playout like this in my mind (Base+VSP+MASP+ISP+BAS+BCSP+BAH+FAP):

Year 1: 55,735 + 5000 + 15,000 + 26,000 + 2880 + 0 + 18,000 + 51,750 = $174,365
Year 2: 60,372 + 5000 + 15,000 + 26,000 + 2880 + 2500 + 18,000 + 51,750 = $181,502
Year 3: 60,372 + 5000 + 15,000 + 26,000 + 2880 + 2500 + 18,000 + 51,750 = $181,502
Year 4: 68,137 + 12,000 + 15,000 + 0 + 2880 + 2500 + 19,200 + 51,750 = $171,467

Average comes out to $177,209 a year. Of course, that includes the money already paid to you as FAP, so only $125,459 will actually show up on your LES.

-I assumed promotion to O-4 at year six, with all three years in residency counting toward pay and rank
-I assumed $1500 per month for BAH with a $100/month increase with promotion
-I assumed separating at earliest possible date, which precludes signing MSP during year 4 - hence the zero in that spot
-I assumed that - on average - board certification would happen after the first year, since some exams are in the spring and some are in the fall

 

[Apollyon]

Just a note for EM boarding - colb is correct. The qualifying exam (written) is in the fall. Provided one passes, the candidate is randomly assigned to spring or fall; as such, there's about a 50% chance that the oral exam (certification) will be the following fall. That is about 16 months after finishing residency.

 

[pgg]

I did not see anyone getting ECISP in the Army.

I don't believe any service has actually implented it.



OP, keep in mind that just because Congress authorizes the branches to do stuff and spend money doesn't mean the services will actually do it. Cases in point: ECISP, various retention and accession bonuses ...

... and probably the 15-year early retirement thing that Congress recently authorized. It would be pretty astonishing if they extended that offer to physicians.