Considering HPSP and FAP

[LBB2031]

I’m hoping to begin medical school in fall 2013 and have been looking into HPSP. I’ve always wanted to serve in the military, so initially HPSP seemed like a no-brainer. However, the more I’ve read, the more I’ve come to understand that taking the HPSP scholarship is no slam dunk option. There are all kinds of variables in the HPSP program (do you get to train straight-through, the quality of your residency training, do you spend two years as a GMO, etc.) that have an impact on the doctor you become. While this impact isn’t inevitably negative, it seems like a fair number of HPSPers feel that their military obligation compromised their medical training or, at the very least, made their task of becoming the best doctor they could be a lot more difficult. I’ve concluded that if my main goals are (1) serving in the military and (2) becoming the best doctor I can be (and I set aside any financial considerations), then it would seem that waiting until residency to join (via FAP), or even waiting until post-residency to join, are safer paths than HPSP. And by “safer paths” I mean that they minimize the impact the military can have on my medical training and development as a doctor.

Here’s my concern, however, with this line of thinking: if I wait around until residency or post-residency to join, the military experiences that drew me to military service in the first place will no longer be available to me. What I’m getting at is I’m concerned that the type of billets that would typically be available to a residency-trained doc (especially a non-primary care doc), wouldn’t be all that different than what you’d find in civilian practice. I mean, let’s say I sign up for FAP as a surgical resident (I know I’m getting way ahead of myself, but I’ve always been interested in surgery). Won’t I just end up being a surgeon in a hospital, just like I would end up being in the civilian world (granted it would be a military hospital treating servicemembers and dependents)?

And while a fully-trained surgeon that joined in the past ten years could be guaranteed a deployment to Afghanistan/Iraq, given that I’d be starting active duty in about the year 2022 if I took the FAP route, who knows what opportunities there would be to serve. Anyone care to speculate what kind of deployment possibilities there would be for residency-trained, non-primary care docs in a post-Iraq/post-Afghanistan world?

To me, the point of being a doc in the military is to get to do things you would never get to do in civilian medicine (e.g. be assigned/attached to a line unit and have the honor of caring for those brave men and women, get to go out in the field occasionally on some training exercises with the unit to provide care, deploy with the unit). From what I’ve read, maybe something along the lines of a GMO tour with a Marine unit. Are there chances to do these things as a residency-trained, non-primary care doc? Or if these are the military experiences that I want to have, is the HPSP (and a GMO tour) the best way to go? (And I’m not sure how much of a limiting factor this is, but I’m a female. I’ve read on this forum that this means I can’t be a battalion surgeon with an infantry unit. But does anyone know whether the recently announced Pentagon policy change affects this? As I understand it, the 1994 policy prohibited women from being assigned to combat units in positions below the brigade level. However, the new policy opens some battalion-level positions in these units to women. Is battalion surgeon with the infantry one of them?).

Any insight into these questions would be much appreciated. This forum has been a great resource for me, and I’m so thankful to all who contribute.

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[GMO_52]

In general, a staff surgeon would not deploy in a GMO role.

As far as the rest of your questions and what the military will be in 2022...your guess is as good (or bad) as anyone's.

 

[Cooperd0g]

I look at it two ways: some folks want to "just be a doctor, but do it in the military serving troops" and others are interested in the "things you can't do as a civilian doc, AKA GMO stuff."

You can be a non-primary care physician and still be a GMO. I have seen only one personally, but have been told there are more. At my current command one of the flight docs is an ophthalmologist and the other is a "standard" GMO guy who did his internship and is waiting to start his residency. In the meantime he trunks flights in Hornets, Rhinos and Vipers.

I think opthalmology might be easier to be a flight surgeon as vision is pretty high up on the scale for pilot stuff though. This guy isn't doing any surgeries that I know of so he is probably having some skill atrophy there. Ortho, ENT ... I would say those are unlikely. Rads, Anesthesia, Derm ... you might be able to pull it off, but I really don't know.

To me it seems like if you are hell bent on a surgical specialty you would have to decide if your primary focus was to be a doc and end up working for the military or if you wanted to do the flight surgery, battalion surgeon or dive medical things. Then choose FAP or HPSP accordingly. I don't know how the military residencies rate compared to civilian. I imagine some are better than others, but they are all accredited programs.

Consider this possibility: Do HPSP so you can get your GMO "fun" (note, you are not guaranteed to have fun, but I can almost guarantee it will be an "adventure" of some kind). Then separate for a civilian residency. Then go back in the military as an attending - you get to choose your own residency based on your performance and match capabilities. Of course, that would be a little silly considering you would lose out on a fair amount of income during that residency time.