Debt and HPSP

[Cachito]

I am currently applying for both the Navy and AF HPSP programs. Applications are to be finalized by the end of this month and I am still uncertain on whether I really want to commit if I am offered a scholarship.

I have read all of the pertinent threads for HPSP on this forum and am very appreciative of all who have shared their thoughts and wisdom.

My medical school debt will be close to $200k. I have researched enough not to do HPSP solely for the money. However, in doing cost-benefit analyses for "military medicine vs civilian medicine," I have consistently reached my dilemma: define "debt." On one hand, the HPSP will leave me financially "debt-free" with a rank, benefits/bonuses, and experiences that I will never have the chance again to have as a 60yr old doctor (not to mention the chance to serve my country). However, I will owe them 4+ yrs of service and will be at the government's disposal for that period of time (personal debt). On the other hand, the civilain route will leave me with a financial debt looming over my head for God knows how long. However, I will have sole proprietorship over the course of my career.

I come from a military family and I know what military life is like. However, I can't visualize what it is like to be both a physician and a soldier/sailor/airman. The duality of serving the misison of the military as a physician places many question marks in the future of my career. I don't plan on being in the military past the payback period. I have bombarded my recruiters with specific questions of the commitment HPSP entails and I am clear on what medical school will be like with HPSP. However, I don't know if the experience as a military physician is worth the personal "debt."

This post is ideally intended for those entering the "payback" phase of their HPSP commitment. Was it worth it? Was it everything you expected? Do you regret it? Do you feel you would have missed out on a great opportunity if you had decided against HPSP when you were entering med school?

Thank you in advance.

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[militarymd]

search and read my posts from dec 2003 forward.

 

[USAFdoc]

I am currently applying for both the Navy and AF HPSP programs. Applications are to be finalized by the end of this month and I am still uncertain on whether I really want to commit if I am offered a scholarship.

I have read all of the pertinent threads for HPSP on this forum and am very appreciative of all who have shared their thoughts and wisdom.

My medical school debt will be close to $200k. I have researched enough not to do HPSP solely for the money. However, in doing cost-benefit analyses for "military medicine vs civilian medicine," I have consistently reached my dilemma: define "debt." On one hand, the HPSP will leave me financially "debt-free" with a rank, benefits/bonuses, and experiences that I will never have the chance again to have as a 60yr old doctor (not to mention the chance to serve my country). However, I will owe them 4+ yrs of service and will be at the government's disposal for that period of time (personal debt). On the other hand, the civilain route will leave me with a financial debt looming over my head for God knows how long. However, I will have sole proprietorship over the course of my career.

I come from a military family and I know what military life is like. However, I can't visualize what it is like to be both a physician and a soldier/sailor/airman. The duality of serving the misison of the military as a physician places many question marks in the future of my career. I don't plan on being in the military past the payback period. I have bombarded my recruiters with specific questions of the commitment HPSP entails and I am clear on what medical school will be like with HPSP. However, I don't know if the experience as a military physician is worth the personal "debt."

This post is ideally intended for those entering the "payback" phase of their HPSP commitment. Was it worth it? Was it everything you expected? Do you regret it? Do you feel you would have missed out on a great opportunity if you had decided against HPSP when you were entering med school?

Thank you in advance.

read my posts; you have to decide what is most important to you;
is it money, freedom, autonomy, your family etc.
in my opinion, joining military medicine loses out on most all of these. And many of the "fringe benefits" and ideals/core values of the military have eroded away and have been replaced by goals of money and metrics.
Your decision, In my opinion it is very one sided to keep your freedom, ability to practice with some amount of autonomy, and keep your options open.

"AVOID MILITARY MEDICINE if at all possible."

 

[The White Coat Investor]

I don't plan on being in the military past the payback period.Thank you in advance.

There's your answer. If you wouldn't do it without the money, you shouldn't do it. You are, in fact, doing it for the money, just like I did. And you will regret it. If you are having that hard of a time deciding, do this: DELAY YOUR DECISION.

The military will let you sign up next year, the year after that, as a resident, or even after you graduate. The financial benefits will be about the same then as they are now. The fact that you have read all the posts here and are still undecided says to me you shouldn't sign up.

 

[cmeshy]

This is a little off the context of the OP, but I think this is important to us students who are pondering the question of accepting these scholarships. Getting a realistic picture in this forum is becoming impossible. What I am questioning is how in the world do you "militarymd and usafdoc" have so much free time (since I'm taking you are both practicing physicians) to be nearly the first to post a response (mind that it is always negative) to every question that is brought up in this forum? I for one do appreciate that you can give actual "been there" knowledge but your persistence is really starting to make me question your intentions here. Don't you have a job, life, anything other than being the first here to strengthen your agenda? I mean seriously??? The adult physicians I have worked with, including military ones, don't spend so much time hanging with us kiddies and try to force their opinions down our throats. I really am perplexed.

I think there needs to be a sticky saying "be wary and warned of the frequent negativity that is dominated here by a small few"...and we all know who you are.

Again, just to clarify, I am not trying to wage a flame war here or question your experiences (although from reading so many posts of yours I feel like I was there wallowing in the misery with you) I am just overwhelmed at your guys lifestyle in front of the keyboard.

 

[militarymd]

cmeshy,

I have made it clear what my intentions are:

1) warn about the state of military medicine
2) contribute to its utter and complete failure so that they FIX it


There are more than just a few negative experiences....however, only a few (myself and USAFdoc) are committed enough to continue to post.

There have been many (double digit) fully trained physicians who have posted here over the last 2 years that I've been here. They mostly have moved on.

I feel committed.

As for time, I'm in private practice....I'm living a life that I could never have while on active duty.....despite the time I spend on the internet...both business related and personally related (SDN)....I still spend MORE time with my wife and kids.....

 

[edinOH]

I'm not, nor have I ever been a military physician, but I did serve five years active duty in Navy medicine prior to medical school. I too considered HPSP and weighed the cost/benefits similar to how you are doing it.

Ultimately I looked at the debt this way. What if an organization offered to pay all of your medical school tuition and living expenses, and all you had to do in return was work for them one half to one full day a month for your first 10-30 years of your practice? You would work one half day a month for 30 years or one day a month for 10. You could do this in any specialty you choose, any city you want to live in, and in any practice arraingement that fit you. Doesn't sound too bad does it?

That is essentially the deal you will be making with yourself if you decide to take out loans to pay for your medical school. Ultimately your "commitment" to repay your loans will be approximately one day a month of salary. This is on average. I would much rather go on "active duty" for the U.S. of EdinOH for one day a month than the U.S. of A. for every hour of every day for the next 4-7+ years and all the other hassles that go with it (which have been rehashed at length on these boards).

This logic does not take into account the intagnables such as duty, service and desert experiences, just the financial and life-style cost/benefits as mentioned.

Student interest rates are extremely low...better than inflation low. Your student loan payments will be several hundred to about a thousand dollars a month. Unless you do IM, FP or peds, this will not hurt you too much once you start practice. Even if you did one of the above mentioned, you would still have several thousand dollars a month of disposable income each month within a few months of residency graduation. You will still have plenty left over.

That's just my opinion.

 

[USAFdoc]

cmeshy,

I have made it clear what my intentions are:

1) warn about the state of military medicine
2) contribute to its utter and complete failure so that they FIX it


There are more than just a few negative experiences....however, only a few (myself and USAFdoc) are committed enough to continue to post.

There have been many (double digit) fully trained physicians who have posted here over the last 2 years that I've been here. They mostly have moved on.

I feel committed.

As for time, I'm in private practice....I'm living a life that I could never have while on active duty.....despite the time I spend on the internet...both business related and personally related (SDN)....I still spend MORE time with my wife and kids.....

I agree with everything said above. Though we are in very different specialties, we both now have a professional career and home life that is so much better than what the military currently enforces on its physicians.

Cmeshy; you may not believe me, thats on you, but I have spoken personally to about 30+ family clinic docs/providers during my time in and they are "hated" what the USAF was doing to Primary care. "Hated it" I really beleive all (100%) would have resigned immediately if given the choice.

I wish the best for those of you that are going in, really I do. I hope the military changes the direction of what they are doing. But the truth is the truth. Recruiters, advertisements on TV, medical journals etc all lie to you all about what is really going on. The physicians here on this site take our time to tell you what we experienced, what we saw first hand and what we know from of colleagues who do not take the time to inform you on this site.

You take from it what you want. At least you are being given the opportunity to make a more informed decision.

Lastly, my fight is not with anybody on this site (although that IgD character certainly makes staying calm challanging). My fight is with the Surgeon General and his staff that know what is going on, have the power to implement change, and still continue to look the other way. I have more things going on with congress, and Lord willing, hopefully that will force some change for the better of patients and staff.

 

[bobbyseal]

Don't you have a job, life, anything other than being the first here to strengthen your agenda? I mean seriously???

I am just overwhelmed at your guys lifestyle in front of the keyboard.

Instead of doing the sudoku between cases, I'm sure milmd is posting on sdn. The other night I saw a 3am post. Were you between placing epidurals on labor and delivery and had a spare moment?

After my anesthesia rotation, I kind of smacked myself and asked why do I want to do surgery? I could be like the anesthesia residents and complain about having to take call Q4 for one month while on the ICU.

 

[militarymd]

Instead of doing the sudoku between cases, I'm sure milmd is posting on sdn. The other night I saw a 3am post. Were you between placing epidurals on labor and delivery and had a spare moment?

After my anesthesia rotation, I kind of smacked myself and asked why do I want to do surgery? I could be like the anesthesia residents and complain about having to take call Q4 for one month while on the ICU.

Must have been after a epidural.

 

[island doc]

This is a little off the context of the OP, but I think this is important to us students who are pondering the question of accepting these scholarships. Getting a realistic picture in this forum is becoming impossible. What I am questioning is how in the world do you "militarymd and usafdoc" have so much free time (since I'm taking you are both practicing physicians) to be nearly the first to post a response (mind that it is always negative) to every question that is brought up in this forum? I for one do appreciate that you can give actual "been there" knowledge but your persistence is really starting to make me question your intentions here. Don't you have a job, life, anything other than being the first here to strengthen your agenda? I mean seriously??? The adult physicians I have worked with, including military ones, don't spend so much time hanging with us kiddies and try to force their opinions down our throats. I really am perplexed.

I think there needs to be a sticky saying "be wary and warned of the frequent negativity that is dominated here by a small few"...and we all know who you are.

Again, just to clarify, I am not trying to wage a flame war here or question your experiences (although from reading so many posts of yours I feel like I was there wallowing in the misery with you) I am just overwhelmed at your guys lifestyle in front of the keyboard.

Read my posts. As a physician my job is to alleviate human suffering. That is what I am doing posting here, my job. I am working to alleviate human suffering by informing those considering entering the AFMS (Air Force Medical Service) of the suffering that they will experience if they do. Whether or not they choose to listen is another thing.

 

[XXBlockheadXX]

I hope I can address some of the OP questions. Though I do not quite fit the profile of one entering my payback period, I have what society might consider advanced business training. The monetary debt of personal loans through the government and alternate loans, by nearly all accounts, is not overcome by the scholarship/stipend/physician pay in the military compared to what the market will offer upon completion of your training. There is nearly certain financial sacrifice involved in military service as a physician.

Just because you don't make a career out of military service, this does not diminish the value of time served. I have great respect for those in this forum who have served honorably, even if they speak ill of their experience. They, too, sacrificed (though more than they expected to, perhaps).

However, you must consider your personal situation/goals and measure it against the costs and benefits of each path into military medicine if you find that it is a sacrifice you are willing to make; there are gradations of sacrifice with each path.

Always evaluate your situation with sober honesty.

 

[IgD]

Was it (HPSP) worth it? Was it everything you expected? Do you regret it? Do you feel you would have missed out on a great opportunity if you had decided against HPSP when you were entering med school?

I think HPSP was definetely worth it for me. I went to a very expensive private medical school. I received straight through training in a subspecialty. Later I was selected to be chief resident and even became a published author.

I would have missed out a lot if I would have financed my own medical education. My family and I had a higher quality of life because we had no debts and military residency pays double what you make as a civilian. We were able to make a significant amount of money by careful investing before I even graduated my residency.

When you start your "payback" you can expect to do a utilization tour. This is when the military sends you somewhere no one else wants to go. This can actually be a great thing because you are a big fish in a small pond instead of the smallest fish in the biggest pond.

Read the posts here with a grain of salt. There are a handful of people who seem to get a sexual thrill out of convincing people not to start a career in military medicine.

 

[Galo]

an idg rant



Read the posts here with a grain of salt. There are a handful of people who seem to get a sexual thrill out of convincing people not to start a career in military medicine.[/QUOTE]


Cachito,

Read as much as you can. Both USAFdoc, and Militarymed, myself, Island doc, have expensively posted our negative experiences as miltiary physicians. Certainly, if we had time machines many of us may choose a different life. This is a choice you will have to live with for the rest of your life. I, like the other experienced military physicians post our negative experiences for the benefit of others making a more informed decision, and hopefully to make the military change, although I think that will never happen. Feel free to email me, if you want to talk privately. I think the more experienced physicians you talk to, the better picture you will get about how unhappy a majority of them are in the military today.

As for people like Igd, I can now add sexual deviant to his agenda. None of use have ever mentioned sex in any way, shape, or form, when describing our military experience, but you can see from his post, and many of his others, (just do a search), that this is one of the people your are likely to run into in the military. Although you may find a ton of great people, it just takes one person like him to ruin what may otherwise have been, an acceptable 4 years. My advice, get good education and training, you will pay your debts and be better off. You can always join after you get training in what you want.

Homunculus, what's the rules on sex here. I think idg is horny!

 

[XXBlockheadXX]

By taking something with a grain of salt, assume that IgD is trying to encourage undertaking sound judgment, rather than swallow the prevalent negativity whole, without looking into it for ones self.

Just as one would be sorely disappointed (as many on this forum are) if they entered military medicine in a blind fury, so to would poor judgment be exercised if they turned away from military medicine by relying solely on the negative experience found here, though would be wise to add this to their considerations.

Likewise, take overwhelming optimism from IgD with a grain of salt.

Equal opportunity saltiness, I say.

 

[cmeshy]

cmeshy,

I have made it clear what my intentions are:

1) warn about the state of military medicine
2) contribute to its utter and complete failure so that they FIX it


There are more than just a few negative experiences....however, only a few (myself and USAFdoc) are committed enough to continue to post.

There have been many (double digit) fully trained physicians who have posted here over the last 2 years that I've been here. They mostly have moved on.

I feel committed.

As for time, I'm in private practice....I'm living a life that I could never have while on active duty.....despite the time I spend on the internet...both business related and personally related (SDN)....I still spend MORE time with my wife and kids.....

Ok, so you are committed! You've made that abundantly clear with what, over a 1000 posts. Seriously, do you not think people that come to this site for advice will not question what the heck you are up too? Your committment is quite obvious and quite easy to see through.

What I and I'm sure many would like to hear you say in your slanderous posts, is that YOU joined for all the wrong reasons. YOU had already decided that the military was beneath you and that YOU would do your time as quick as possible and get the f out. YOU never gave anything a chance, because with that kind of character, misery is all you got. I've seen it before in my previous enlistment and somewhat fell victim to it as well, but not to the hatred that you possess now. The grass is greener on the other side is a true sentiment to people who live only for the future and never enjoy the now. I really would take a long hard look at what is eating you!!! DON't BLAME the MILITARY for your shortcomings and bad desicions.

I for one appreciate what I went through and have both good and BAD things to say for my experience. The military is not like the civy world, nor should anyone signing up think it is. Do you really think they are that foolish? It is COMMON knowledge that recruiters give half truths, BUT i still respect them for their near impossible odds in gaining new recruits. This scholarship gives options for people like me who don't have trust funds or rich parents to pay for tuition.

OK, so you say that military medicine is off its rocker. Again I'm sure and would hope that anyone joining is aware of these problems too. Guess what, the rest of the nation has problems as well. Why do you attempt to possibly stear away new physicians who may be beneficial and aid in reform. I can see how with leaders such as yourself with your negative attitude accomplished nothing.

You are committed? WHY??? What are you getting out of this insistent ranting and raving about how miserable you were? "I'm trying to save others from making the same mistake." I got an idea. Let people make their own informed decision. Cause surely by now, they should know all the negatives since you have spelled them out 1000 times.

I'm not sure what I'm am trying to get out of this post, but I think that seeing your name nearly every other post in each thread is just getting to me. Again, what are you so committed for??? 1000 posts!!! Who has the time for that kind of committment with such hostility involved? It can't be healthy. Find a new hobby please cause your keyboard time would raise the eyebrows of most psych docs I'm sure. And again, I'm not saying that I don't want to hear the bad side as much as the good side, but the overwhelming negativity found here has just made me need to speak my mind.

I am going to take this scholarship and enjoy my time. Will I stay in and make a career? Who knows. But I definately am going to try to get the best of what the military offers to what can't be found in the civy world. Travel, take a bullet for your friend style friendships, and blowing things up. After all I am a guy and blowing things up is in our genes. Is it in yours milmd???

I guess that is all.

 

[iatrosB]

Ok, so you are committed! You've made that abundantly clear with what, over a 1000 posts. Seriously, do you not think people that come to this site for advice will not question what the heck you are up too? Your committment is quite obvious and quite easy to see through.

What I and I'm sure many would like to hear you say in your slanderous posts, is that YOU joined for all the wrong reasons. YOU had already decided that the military was beneath you and that YOU would do your time as quick as possible and get the f out. YOU never gave anything a chance, because with that kind of character, misery is all you got.

I am pretty sure that he stayed beyond his obligation and attempted to stick it out...but just could deal with it anymore...can't hate on someone for that!

 

[militarymd]

I am pretty sure that he stayed beyond his obligation and attempted to stick it out...but just could deal with it anymore...can't hate on someone for that!

I did...I freely signed up for 2 additional years of obligation by taking a fellowship that was unpopular in my specialty.

 

[notdeadyet]

I am going to take this scholarship and enjoy my time. Will I stay in and make a career? Who knows. But I definately am going to try to get the best of what the military offers to what can't be found in the civy world. Travel, take a bullet for your friend style friendships, and blowing things up. After all I am a guy and blowing things up is in our genes. Is it in yours milmd???

I have a hunch milmd and many of the others probably thought they'd enjoy their time as well. Congrats on your med school acceptance. Once you get your degree and finish your residency and report to active duty, please be sure to post your experiences. I'm deciding on whether to go the scholarship route but I find it very interesting that a VAST majority of positive postings about military med come from those who have not yet served as active duty physicians.

Also, as an aside, if you're interested in taking a bullet for a buddy and blowing things up, med school seems a pretty circuitous route to do it, no? I'll bet if you call a recruiter, they can get you signed, trained, and having exactly those experiences before summer's end.