Full Deferment and Navy HPSP

[JA_Perez]

---

Members do not see this ad.

If an HPSP student is interested in asking for a full deferment in order to look for a Radiology residency in the civilian sector, what kind of credential does he needs? Any cutoff in terms of step 1 or 2, average, class ranking? Thank you in advance.

 

[Navy Dive Doc]

If you have the credentials to get into a civilian radiology residency, you should have the credentials to obtain a deferment. The big problem is whether or not the navy is giving any deferments for radiology your year. They just opened a new residency at Naval Hospital Portsmouth, so that adds 5 more people to the pipeline each year. My suspicion is that the Radiology deferments may go down significantly. The Navy only defers people to meet projected specialty shortfalls, not desires of the HPSP student, so be sure to look into the Navy internships and follow on GMO tour options, no interns are being picked up for straight through training in Radiology. I know, I'm applying to go back to radiology along with A BUNCH of other returning fleet guys. Hope this helps,
DD

 

[Teufelhunden]

Originally posted by Navy Dive Doc
The Navy only defers people to meet projected specialty shortfalls, not desires of the HPSP student

Dive Doc,

Is there anyway to forecast exactly what those projected specialty shortfalls are going to be?

I'd really like to avoid doing a GMO tour, so knowing this information could be helpful, i.e. if I'm still borderline when it comes to choosing specialties, I may choose the one that the Navy would be most likely to allow we to go straight through.

I'm 32 yrs old, prior-service Marine Corps....I'll be 34 when I graduate...after internship and GMO tour I'll be 38....I really don't want to be a 38 y/o PGY2.

Anyway, a few years ago at OIS, they said that "priors" had a better chance at going straight through (?fingers crossed?). The rationale, supposedly, was that...for example, in my case....I have 6 years towards retirement already...that I would be more apt to do 20 (yrs) than someone with no prior service.

It kinda makes sense....after GMO and residency....I'll only have 7 years left 'till retirement --> 20 minus 6 (prior service) minus 3 (GMO) minus 4 (residency). Anyway, is there any truth to this?

 

[Navy Dive Doc]

Teufelhunden,
With your prior service, and therefore the years in service pay increase, you'd be crazy to pursue a full deferment and live on civilian residency salary vs. Navy pay.
Regardless of your long term specialty choice, you're going to match in an internship only out of med-school, so this makes picking a little easier. You should have a good idea if you are an internist vs. psych vs. surgery type, and that can guide the internship choice. If you're undecided between specialties, and are looking at say medicine vs. radiology, you can always match for an internship in medicine and decide later, you need the clinical base year anyway if you choose rads.
You do get priority for straight through training if you're prior service, for the reasons you stated as well as the fact that you've paid more dues to the military than others. It's not a huge plus factor, though, and it won't trump someone's GMO tour if you haven't had one.
Historically, here's the breakdown of specialties and likelihood of getting straight through.
Almost certain - Medicine, Psych, OB-GYN, FP
Highly variable, possible - Peds, ENT (2 interns my year)
No Chance - Gen Surgery, Ortho, Ophtho, Derm, Radiology, Emergency Medcine, Anesthesiology.

Remember, though, if you do staight medicine, you'll almost certainly need to go out and do a utilization tour as a general internist before coming back for fellowship. Those who did come back from GMO land would have priority over those with no fleet time.

Things do change. My year, 4 of my fellow transitional interns walked into anesthesia spots because it wasn't popular 4 years ago...it sure is now

Finally, don't look at the GMO tour as necessarily bad. The non-Dive or Flight spots are only 2 years, there are even a few single year GMO spots overseas (unaccompanied). I'm very thankful for my tour. I could have trained straight through in anesthesiology, I said no and went Dive, have had a great time and am going back for Radiology after a lot of time to think about what I really want to do. I'm much better off for the tour, though I can understand your situation, I'll be 32 not 38 when I go back. Hope this helps,
DD

 

[brats800]

where's aerospace medicine on the list? i'm assuming its also in the 'no chance' bracket...

also, those brackets are pretty close to how competitive a residency is in the civilian sector, right? (ie - its not too hard to get a fp residency but still challenging to get emergency meds at a civilian program, right?)

 

[iwakuni_doc]

The Navy's Residency in Aerospace Medicine is no longer a primary residency program. Applicants to the RAM program must have already completed another clinical residency prior - this was a new change while I was down in Pensacola. Only time will tell if this holds up - I wonder if there will be enough applicants to keep the pipeline filled?

 

[JA_Perez]

Navy Dive Doc:

It is pretty clear that I have to do a GMO in order to get a rad's spot. Is there any chance of landing in Rota, Spain. Will the fact that I speak spanish(I am from Puerto Rico) help me?

 

[Navy Dive Doc]

JAP,
Sorry, but you will not go to Rota Spain as a GMO. I don't even think there are GMO billets, if they were they would definitely go to 2nd tour GMOs. Rota is considered the premiere overseas job in the Navy, fought over in all specialties. There is one GMO job in La Madelena, Sardinia that opens every two years. It's on the SUbmarine tender, a ship with a very large female contingent. Because of this, the GMO they took my year had to be a woman to help with standby issues for pelvic exams. It's a bad job anyway, though I met a submarine in La Mad and it is a nice place.
Naples, Italy, maybe though I don't remember any GMO spots. Guam, Japan are the only overseas places with a fair number of GMO spots, as well as FS and DMO.

Iwakuni is right, Aerospace medicine is now a second residency after you're already boarded in something else. There was a residency in Undersea medicine, but that's been canned altogether.

Yes, generally the competitiveness reflects civilian trends, with the wierd exception of ENT. It's highly variable from year to year, though never in truly high demand. My year they took 2 interns for the 3 spots on the east coast, there just weren't enough fleet returnees. Maybe it's because the residency is so long (5 years after internship) and most of us who have been in the fleet realize we just don't want to sign back on for training that is so long. You get used to being on your own as a GMO, it can be hard to go back.

DD

 

[Teufelhunden]

Dive Doc,

First of all, thanks for your thorough reply. HPSP doesn't do a great job at getting info to us...it's nice to have someone around to give us the 'scuttlebutt.'

Originally posted by Navy Dive Doc
The non-Dive or Flight spots are only 2 years, there are even a few single year GMO spots overseas (unaccompanied).

What is a 'non-Dive' spot?

Is there somewhere I can get a list of these 1-year unaccompanied overseas tours you mentioned? Do you know anyone who's done them? (I can only imagine that we're talking Haiti, Diego Garcio, Gitmo, etc ?)

 

[iwakuni_doc]

If you're interested in what kind of billets are out there, you can take a look at the BUPERS website:

http://www.persnet.navy.mil/pers4415/medical_corps.htm

It has links for all of the specialty billets as well as the FS, DMO, & GMO billets - so you can get an idea of what is out there. Just remember that if it looks like a great billet & location - it probably won't be available as a 1st tour assignment, although miracles do happen.

Please don't email any of the detailers listed on the page if you're not already in the Navy & seeking a billet. Their job is to put Navy doctors into needed billets - they're not an information service.

 

[Navy Dive Doc]

T,
By non-dive or flight I mean regular GMO tours that start right out of internship and don't require the six month training programs that Diving Medicine or Flight Surgery require. If you do the DMO/FS route, you have the 6 months of training, then sign a contract stating you will do 2 years minimum as a FS/DMO, and that really means 2.5 years to get back on the residency time frame, so 3 years total, minimum for flight surgery or dive medicine
I do know a few people who did the one year tours. They went to Okinawa as GMOs with Marines. Diego Garcia and Bahrain are FS and DMO tours, respectively but doing those tours does not release you from your 2 year minimum tour, you just get to finish somewhere else.
Remeber, unaccompanied means the Navy will not pay to bring your family. You can pay their way, though, which my friends did with their wives...they weren't separated for the year, it just cost them some money for plane tickets. Check the site that Iwakuni posted, just remember that is what's available for next year, it's not an exhaustive list of all billets.
DD

 

[Teufelhunden]

Originally posted by Navy Dive Doc
Historically, here's the breakdown of specialties and likelihood of getting straight through.
Almost certain - Medicine, Psych, OB-GYN, FP
Highly variable, possible - Peds, ENT (2 interns my year)
No Chance - Gen Surgery, Ortho, Ophtho, Derm, Radiology, Emergency Medcine, Anesthesiology.

Is this the breakdown for going straight through in a Navy program? What about a full-deferment for a civilian program? What's the likelihood there? It seems that the above list is the way it is d/t GMOs competing for (and being preferentially selected for) more competitive programs.

Originally posted by Navy Dive Doc
With your prior service, and therefore the years in service pay increase, you'd be crazy to pursue a full deferment and live on civilian residency salary vs. Navy pay.

Your point here is well taken. However, my chances to match into a competitive specialty are much greater on the civilian side than military (I'm a DO, so can apply through both matches).

I'm beginning to regret my choice of going Navy and am now wishing I would have went Army or USAF. It's disappointing to know that no matter how much I impress any program as a 4th-year, I can't accept any spots offered me.

Recently a classmate of mine with very average scores was offered a Derm spot at Cleveland Clinic after rotating there. I now realize that these types of opportunities are not there for me, as I am committed to applying for internship only.

Does anyone have any info on Navy full deferments? What are the chances of getting one? What specialties are more likely to get the deferment? What can I do to increase my chances of getting one?

 

[jnytrama]

Teufelhunden,

What Dive Doc told you originally is right on the money. I'm a Navy Medical HPSP Program Manager here in SD, and I'm in charge of submitting their kits to the board. As a result your questions have already been specifically addressed by CAPT Cynthia Macri (PRESIDENT of the professional review board and Navy GME coordinator nation wide for 2001-2003).

In accordance with her gouge that she put out, for FTO (Full Time Outservice deferrment) less than 10% of all HPSP graduates each year are granted FTO. Of those that are, it is totally dependant on what the end strength short falls are projected for that year. that means that for example RADS, 4 years from the year you gradaute they look at if they think they are going to be shrot RADS. If so then they number of FTO's for RADS will go up, assuming they can fill all their Navy RADS billets. So to answer that part of your question, what specialties are allowed FTO's is dependant on the year.

What can you do to make yourself more competetive?

You need to be the number one student in your med school graduating class. You need to have S*#t HOT credentials and people who know you (NAVY MEDICAL PEOPLE) pulling for you. And I'm not talking about some petty officer 2nd class on some ship out there, I mean directors of programs specifically the specialty advisor for the specific program you are applying for (get my drift?)

Also, you should be communicating with your specialty advisor anyway to get a feel on if they think their numbers will be low (x years from when you graduate). (the x symbolizes the length in years of your residency). That way you can see if you have a chance.

FTO's are not to be taken lightly. It is not as attractive to those physicians that plan to make it a career in the military. it's often a double edged sword that mroe often than not cuts in the most unlikely or unpredictable direction.

For example, if you are in FTO you will not receive any military evaluations and when it's time for promotion you will not be competetive against your counterparts that are doing a GMO tour. There are many people that have failed to promote as a result. With your prior service, this would truly be a shame.

In your case specifically, assuming that RADS will be short at the time when you are projected to garduate from your RADS residency, there probably will be opportunities for you to apply for FTO. You have prior military service as a DEVIL DOG and that is helpful, however it is no replacement for experience as a Naval Officer. If you were say, a former Navy Nurse, or a Navy MSC officer or some other officer in the realm of Navy Medicine, the GME coordinator could reasonably say " well this guy at least knows Navy Medicine, so if he goes FTO it won't hurt his career and won't set him up for failure when he comes out and I put him overseas somewhere as his first tour" See my logic?

However lets say the stars are all in alignment and that the planets are all circuling the right way, and you DO get picked up for FTO. . . take note of the following:

BE SURE TO SUBMIT EVERY YEAR A LETTER OF EVALUATION FROM YOUR RESIDENCY COORDINATOR TO BUPERS FOR INCLUSION IN YOUR OFFICER SERVICE RECORD. At least then when it IS time for you to get promoted, the promotion has SOMETHING to look at, instead of a blank screen. Remember, the Medical Corps wants to promote their people, however we have to enable them to do that by providing justification.

I know these are not specific answers to what you are asking, however it is really the best anyone can give you, UNLESS you can get a chance to speak to the RADIOLOGY specialty advisor and get the straight skinny from him. (I recommend this option).

good luck Devil Dog.

V/r

LT QUIKO

 

[BenHoganFan]

Navy Dive Doc who are you ranking first?

 

[Navy Dive Doc]

BenHoganFan,
I'm applying to NMC Portsmouth only, to the extent that it's allowed. I've talked with CAPT Flemming in Bethesda and let him know that he has a great program, but I can't afford to live in DC or San Diego. I know the Navy says we're considered for every program regardless of how many we list, but at least they can't fault me for turning down a spot I didn't ask for. I'll stay in my current billet for another year if I don't match. Are you applying for Rads also? I've heard 58 applicants for 17 spots nationwide, so it's a rough year. Good luck with everything, where are you in Virginia? PM if you don't want it all out there.
DD

 

[BenHoganFan]

Dive Doc,

I am at NNMC. I've met a lot of very competetive candidates and would be happy to work almost all of the people that I have met, thus far.

Here's a web site for applicants if you already haven't discovered it.

http://rad.usuhs.mil/rad/handouts/lonergan/residency_selection/

For the fourth years,

If you are truly competetive enough for the civilian programs, try for a deferrment (research and 230+ boards). I don't know who is getting picked up this year but I have seen LTs to CDRs applying and many have published, have made the grades and the boards to make selection very difficult.

 

[ddmo]

Dive Doc-
If someone wants to do DMO/FS GMO after a 3 year HPSP, what are the odds they could do that for 3 years and then be done with their commitment. That way if they wanted to stay they could do a navy residency, or just get out altogether. I couldn't imagine if you did one of those GMO's for slightly less than your commitment, and then you are stuck with an additional 9 years in the Navy, without choice. Thanks.

 

[Teufelhunden]

Yeah, what's the story on that?

Say you're on 4-year HPSP contract...you do a 3-year GMO tour...now you still owe a year....you enter the Navy match and FAIL TO MATCH...now what?

How do you pay back that final year?

Back to your GMO billet?

 

[jnytrama]

If you don't match you can either take a new set of orders and try again the next year or if you intend to get out you can usually extend on station at your existing billet.

 

[jnytrama]

ddmoore54,

Not sure what your asking exactly. But I'll try to answer.

After a 3 year HPSP you are obligated to serve 3 years on AD as a licensed physician after your intern year. If you do it as a GMO/FS/DMO and do not want to apply for the match you can do your 3 years and you'll be done. At this point you have to make up your mind. You can either take another set of orders and keep doing this without applying for the match and stay in operational medicine for a while until you're bored and decide to either get out or apply for residency. I know of a couple people that have done this and were very happy just having fun!

Or you can just get out after your 3 years.

But you can actually apply for your match during your 2nd year of payback. If you get accepted you would start your residency during your 3rd year of payback and you would payback concurrent with your 1st year of residency. At the end of residency you would only owe one for one for the time in residency. The one year left over for HPSP is gone.

If you wait until your full 3 years is up to apply for match, then after residency you still only owe one for one.

I hope this answers your question. Lots of people think that you have to finish the entire tour before you are allowed to apply for the match. You don't have to wait that long, you can apply during your second year of your GMO/DMO/FS tour.

 

[Teufelhunden]

Originally posted by jnytrama
Or you can just get out after your 3 years.

What if you owe four years? Are you saying that final year of obligation jsut disappears? Or do you own another year as a GMO?

Thanks for sharing this info, btw. You're a wonderful resource on this forum.

 

[Teufelhunden]

Originally posted by jnytrama

After a 3 year HPSP you are obligated to serve 3 years on AD as a licensed physician after your intern year. If you do it as a GMO/FS/DMO and do not want to apply for the match you can do your 3 years and you'll be done.

Okay, I see that you have answered my question. The above scenerio you mentioned described someone w/ a 3-year HPSP contract.

What about those of us who owe four? If we don't match, we're in for 4 years as a GMO, huh?

 

[ddmo]

-jny
Thats exactly what I wanted to know. Thanks!

 

[jnytrama]

Teufelhunden,

Yep. I described the 3 year option cuz I thought that's what you were asking about. In your original scenario you mentioned 3 years as the obligated service.

But yes if you owe 4 years you owe 4 years as a GMO if you don't match. Now however there is about 20% of people who go and apply for the match right out of internship and are allowed to go into residency. So depending on what you want to do, and depending on the currrent needs of the Navy you might be one of those people.

Do you know what you want?

Jny

 

[Teufelhunden]

What are my chances of going straight-thru in Psych, in your opinion?

What about anesthesiology?

Thanks.

 

[jnytrama]

For Psych I think you have a good chance, not as many people want Psych, so it's not as competetive. Anesthesia on the other hand, . . . it's very competetive, also the Navy has Gas Passers on ships and out with the Marines, so they like to have their Residents "seasoned" with some GMO experience. So thought it's not impossible to do Anesthesia straight through, it is unlikely.

For either of these programs in order to go straight through there is one common denominator for ALL interns selected to go straight through . . . They are in the TOP of their INTERN CLASS. So you have to approach your intern year as a true DEVIL DOC and kick ass and take names later. Ensure that you are TEAM PLAYER, and don't make yourself stand out unless it's to EXCELL. That will be your recipe for making yourself even remotely competetive.

Good luck!

jny