For Prior Service.....Is USUHS/HPSP Worth It?

[WhiteDragon]

Hi All.

I have looked at many of the threads on this forum and really appreciate the wealth of knowledge provided by those of you who "understand" military medicine.

Currently I am AD Air Force, enlisted, with a little over 7 years in. I have about three weeks to decide if I want to press forward with my HPSP application or get out of the service and go to medical school. I have been offered a scholarship by my state school - first year tuition and fees paid plus a guarantee that I will receive at least $10,000 in scholarship aid for years 2-4. I have also been accepted to USUHS.

As do most of you on here, I love my military family; I cherish the notion that one day I will be offered the opportunity to care for some of the best men and women this country has to offer, as well as their families. I am idealistic, I want to make a difference, I want to be part of the solution. However, I know all too well that ideals won’t get you very far if you are not in the right position to fix something,

On a personal level, unlike a lot of HPSP candidates, I already have 7 years invested in the service. If I take this scholarship, the payback will put me at 11 years for HPSP, 14 for USU. This is a lot of time to invest considering that I am a nontrad, will be 30 once school starts, if I'm not going to stick it out. I really do worry about being deferred or told that I can't do a residency of choice which would make me even older before I could get out and do a residency of choice. In the hospital, I see mil to civ conversions all the time and many more contract doctors coming in and military docs getting deployed. It seems like the Air Force is contracting out a huge number of specialties and putting less and less of them in blue suits.

I am drawn to the options that a military retirement might offer me: a supplemental retirement and health care coverage for my family and me. However, I would not be surprised if I am required to wait until 65 to receive these benefits.

On a professional level, I am not sure how well I would handle the lack of autonomy that many military docs complain about. Also, I know all too well how the chain of command can work and being told how to do my job/rated by a nonphysician will be very difficult. Probably will happen on the outside though.

With the current ops tempo, I have been told by many residents that there just aren’t enough midlevel docs to provide adequate teaching. Those that have been in for a while have taken a command track and those who haven't have gotten out. Many of the residents feel that there just aren't enough docs with experience around to teach them; this is coming from residents at WHMC!

GWOT has taken up so much money, not to mention BRAC, that the Air Force has put a freeze on PCS moves. Our lab commander was told that he might as well plan on retiring here (he has been here for 2 years and he has almost 4 years left before he is eligible). I am not sure what type of impact this will have on docs, but I can imagine if you were practicing at Minot, Hill, or some other small base that the lack of diversity in your patient cases could not be good for your professional development.

However, I don’t have experience with the civilian side. I'm always told that the grass is not always greener so for those of you who have been there and done that, exactly how green is it? In your opinion, are the uncertainties that I have mentioned worth giving up HPSP/USU and 7 years of service?

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[tscottturner]

I am also prior AD (6 yrs in Army) and was 30 when I started med school. I left AD to go to med school because of the poor state of military medicine (which has finally come to light over the last week or so) and the possibility of never really getting to see my family. In my opinion, your absolute best course of action is to leave AD, but then join the National Guard. You still get paid (a little) while in school, and they CAN'T touch you (for deployment) until after your 2nd year of residency because you are actually classified as a med student. Plus, you still get time towards retirement. You won't be required to do much during your first two years of med school, but after that they may use you to do physicals and similar stuff around the state. As long as you don't accept any scholarship money from the National Guard, you only owe two years - so you could actually leave before you graduate med school if you choose to do so.

 

[The White Coat Investor]

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[USAFdoc]

I"m fairly sour on the whole HPSP/USUHS thing but I think if anyone is happy in military medicine, it is the prior service guys. You will get paid more than the yea-hoos like me, you understand the downsides of being in the military (and presumably are more willing to deal with them), and your commitment time to retirement is shorter. The risk:benefit ratio is much lower, if you get my drift. I still wouldn't do it knowing what I know now, but then again, I would have never enlisted in any of the services. I was one of the guys making fun of the JROTC dudes in high school ("Floating head, floating head...oh wait, that's camouflage")

I was prior enlisted, gung ho military......................the question you have to ask yourself is "do ya feel lucky".
Clint Eastwood said it best.
Anybody getting into milmed is taking a big chance; your residency, your duty station, your family life, the quality of your clinic and the list goes on. I am all for patriotism, but NOT at ANY price. If somebody wants to serve, then have the military pay back some loans AFTER you got your training (and hopefully after the media forces some long overdue milmed changes). Are there some GOOD milmed places out there? PROBABLY. What are the chances you will get one? well, "do ya feel lucky?"

 

[Heeed!]

Anybody getting into milmed is taking a big chance; your residency, your duty station, your family life, the quality of your clinic and the list goes on. I am all for patriotism, but NOT at ANY price. If somebody wants to serve, then have the military pay back some loans AFTER you got your training (and hopefully after the media forces some long overdue milmed changes). Are there some GOOD milmed places out there? PROBABLY. What are the chances you will get one? well, "do ya feel lucky?"

Concur.

I was prior AD for 7 years. It just depends on what you value most: freedom, retirement, location, freedom, loans, freedom, etc. I like the sound of the Guard option mentioned previously...I'd look into that one.

 

[Croooz]

I'm prior service and apply next year. What I'm going to do is go civilian and take out loans for school...preferably a PR school where tuition is cheap. Then once I'm accepted into a residency look into FAP, National Guard, and maybe the Reserves. I would need to do 10 years to retire. Civilian docs without exception tell me I should go in and get the pension. Military docs who are getting out tell me not to bother. I share my office with a Col who retires next year with 27 years. He didn't say I'd be crazy to go back in, he said I'd be ******ed. I'm even older than you and don't have time to flounder in GMO land to gain points to earn a competitive residency.

My issue with the military is the downtime. While there are plenty of deployments to go around those don't equate to working in what you were trained to do. I can't see fighting to get into medical school.....fighting to make it thru....fighting for a residency......then get put out to pasture seeing sickcall in BFE?

The future I see if I joined is when I'm not deployed I would still be putting in some serious hours. I envision the typical 8-10 hours for the military but then another 8-12 hours moonlighting. I know plenty of physicians who moonlight. I also know physicians who didn't moonlight and are retiring and including the pension make as much as their civilian counterpart but not more than their counterpart. I think that's sad.

I would say decide whether or not choosing your own specialty is important to you. If so then forego USU and HPSP. Then decide after you've earned a residency spot whether or not you'll come back in.

BTW, Congratulations on your acceptances! Go to your state school!