Confusion with HPSP and Residency

[Pablo06]

I am confused about how residency match is for the military and civilian, as well as how the two combine. The way this system works will either make or break the deal of me accepting HPSP. Here is the scenario that causes my confusion.

A fourth-year medical student is in the HPSP and is applying for military and civilian residencies. The student does not get accepted to a military residency, but does get accepted to a civilian residency. This residency is not necessarily one that the military considers of great need. Is the student guaranteed the civilian residency anyways? Or is there any chance that the student would be "pushed" into doing a transitional year?

I appreciate any help in this matter.

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[NavyFP]

I am confused about how residency match is for the military and civilian, as well as how the two combine. The way this system works will either make or break the deal of me accepting HPSP. Here is the scenario that causes my confusion.

A fourth-year medical student is in the HPSP and is applying for military and civilian residencies. The student does not get accepted to a military residency, but does get accepted to a civilian residency. This residency is not necessarily one that the military considers of great need. Is the student guaranteed the civilian residency anyways? Or is there any chance that the student would be "pushed" into doing a transitional year?

I appreciate any help in this matter.

To start, the two matches are held at different times. The military match occurs the week after Thanksgiving and results are released in Mid December. So if you are not selected for a military residency, you would need to continue on with the civilian match. Beyond that is more service specific.

Navy - The vast majority who do not match have been given permission to train in a certain field at a civilian program. These are granted by request of the student and the need for that specialty. If, for example, you are selected for a Neurology residency, you would need to obtain a Neurology residency and not an ER residency. Occasionally, there will be a one year deferment but those have almost completely disappeared.

Army - Again, most will be deferred by request.

Air Force - AF gives out full deferments (the AF pays you nothing), full time outservice (AF pays you and you owe more time) and a number of one year deferments. Have not figured out the rhyme or reason for who gets what but I am certain that not all of the one year delays asked for them.

 

[sethco]

If the military does not grant you a military residency, they will either give you a civilian deferment (meaning you find a civilian location to do that particular specialty) or if you are not granted a civilian deferment, you will become a Genral Medical Officer (GMO), meaning you will do your PGY-1 year and then serve as a General Practioner. After you do a minimum 2 year tour as a GMO, you are free to reapply to residency.

Please do a search of this forum. All the answers are right in front of you.

 

[AFIM]

For specifically the Air Force: Plan on doing a military residency - they will tell you that you can get a deferred slot, but they are mostly lying, unless you have extremely extenuating personal circumstances (and maybe not even then). Most importantly, if you are trying to match into a very competitive field, and you don't get it, they will assign you to a GMO slot, not just automatically give you a deferred slot - deferment is rare and granted only to a few individuals each year, depending on the specialty.

 

[MaximusD]

For specifically the Air Force: Plan on doing a military residency - they will tell you that you can get a deferred slot, but they are mostly lying, unless you have extremely extenuating personal circumstances (and maybe not even then). Most importantly, if you are trying to match into a very competitive field, and you don't get it, they will assign you to a GMO slot, not just automatically give you a deferred slot - deferment is rare and granted only to a few individuals each year, depending on the specialty.

How has your experience been with AF IMED? What opportunities ahve been available to you for subspecialization?

 

[LauraDO]

How has your experience been with AF IMED? What opportunities ahve been available to you for subspecialization?

Yes, please share...inquiring minds want to know....

 

[The White Coat Investor]

I am confused about how residency match is for the military and civilian, as well as how the two combine. The way this system works will either make or break the deal of me accepting HPSP. Here is the scenario that causes my confusion.

A fourth-year medical student is in the HPSP and is applying for military and civilian residencies. The student does not get accepted to a military residency, but does get accepted to a civilian residency. This residency is not necessarily one that the military considers of great need. Is the student guaranteed the civilian residency anyways? Or is there any chance that the student would be "pushed" into doing a transitional year?

I appreciate any help in this matter.

If this question is a make or break one for you, don't take the scholarship. I don't blame you, it would have been a make or break question for me too had I thought to ask it. Just so you're on track, let me repeat what others have said:

If you go through the military match and they do not accept you into the specialty you want IT DOES NOT MATTER WHAT THE CIVILIAN MATCH DOES.

You will pass through 3 steps:

1) Military match specialty picking (Here the consultant and program directors in a particular military branch and specialty choose which of the obligated students will "win" i.e. get to train in that specialty.
2) Military match program picking- Here those same people either put you into one of the military residency programs or grant you a deferrment.
3) If, and only if, you are selected in part 1, and selected for deferrment in part 2 do you get to go through the civilian match. Most military medical students DO NOT GO THROUGH THE CIVILIAN MATCH.

It worked out well for me, but part of it was I was lucky enough to have found out how the process worked by September of my 4th year, part of it was the fact that I spent my own money to fly out to the military residency programs to interview personally to tell them I did not want to come to their program but that I really, really wanted to train in their specialty, and partly was the fact that I had really, really good board scores and grades (at least the grades that matter in my field.)

IMHO this is the single worst part of the whole HPSP process.

 

[Pablo06]

Thank you for the information NavyFP and ActiveDutyMD. I greatly appreciate the clarification.

 

[AFIM]

How has your experience been with AF IMED? What opportunities ahve been available to you for subspecialization?

The opportunity to sub-specialize is out there - I haven't done it, but you just have to apply for the JSGME again in whatever specialty you're looking at. Many people get fellowships right out of residency, and if you don't get it the first time, if you go out and spend time in the field, it gets easier to get it the second time. The Air Force definitely rewards rank and experience, for better or worse. How hard it is to get a fellowship depends on how many slots are authorized for that year, and how many applicants there are. I've seen years when everyone who applied for a competitive specialty, such as cardiology, got it, and years in which there were people that didn't get much less competitive specialties. In general, getting a fellowship in the Air Force is *easier* than in the civilian world. That said, there are definitely some questionable doctors who get accepted to do fellowships - scary. Hope this helps.

 

[IgD]

I am confused about how residency match is for the military and civilian, as well as how the two combine. The way this system works will either make or break the deal of me accepting HPSP. Here is the scenario that causes my confusion.

A fourth-year medical student is in the HPSP and is applying for military and civilian residencies. The student does not get accepted to a military residency, but does get accepted to a civilian residency. This residency is not necessarily one that the military considers of great need. Is the student guaranteed the civilian residency anyways? Or is there any chance that the student would be "pushed" into doing a transitional year?

I appreciate any help in this matter.

These are exactly the questions you should be asking. Almost all medical students will be placed in a military internship. The military match precedes the civilian match and the results are binding. By taking the big money, you take a risk and give up some freedom of choice.

In the civilian world, you apply for residency in medical school however in the military you apply for residency during internship. In the military system, there is a good chance you would be pushed into a GMO tour after internship. My friend once had matched to a categorical residency in the civilian world. The military called her up during internship, pulled her out of residency and sent her on a deployment. What really happened is she had only matched for an internship but didn't realize this.

Here are a couple links that may help you understand the process more:
http://www.militarymedicine.com/hpsp
http://www.militarymedicine.com/jsgmesb

 

[MaximusD]

The opportunity to sub-specialize is out there - I haven't done it, but you just have to apply for the JSGME again in whatever specialty you're looking at. Many people get fellowships right out of residency, and if you don't get it the first time, if you go out and spend time in the field, it gets easier to get it the second time. The Air Force definitely rewards rank and experience, for better or worse. How hard it is to get a fellowship depends on how many slots are authorized for that year, and how many applicants there are. I've seen years when everyone who applied for a competitive specialty, such as cardiology, got it, and years in which there were people that didn't get much less competitive specialties. In general, getting a fellowship in the Air Force is *easier* than in the civilian world. That said, there are definitely some questionable doctors who get accepted to do fellowships - scary. Hope this helps.

Excellent. I can definitely see myself subspecializing. Although I really am excited to do IM... the civilian payscale rewards procedures and every IM doc I talk to tells me to subspecialize. I'm keeping my mind open to primary care as it is what I have always wanted to do. What has your experience been with the quality of training in AF internal med?

Thanks for your input -- it's greatly appreciated.