Having doubts about Navy HPSP

[rckelly23]

Hi y'all, I was recently accepted to an osteopathic program and I am almost complete with my application for the Navy HPSP, but I am starting to seriously have doubts about whether I would want to accept it.

I'll be honest and admit that the financial concessions were a big motivation for me to pursue HPSP, especially since my program's tuition is around $46k. I worry about how long it would even take me to pay all of it back.

But I am also really concerned about my obligation to the Navy, more so the unpredictability of it all. What are the changes I would be required to serve a GMO tour? Would it happen before or after residency? Would I have a say in wanting to join a civilian residency? For those who have already accepted the HPSP, would you do it again?

I'm sorry if posts like this have come up countless times before, but I want to make sure I am getting all the information I need in order to make an informed decision. I am currently 24, and within the next 10 years or so I want to settle down, start having a family, and be able to practice medicine freely, but I worry the military would hamper these goals.

Thank you in advance for the insight.

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[pgg]

What are the changes I would be required to serve a GMO tour? Would it happen before or after residency? Would I have a say in wanting to join a civilian residency? For those who have already accepted the HPSP, would you do it again?

High, before, unlikely but not impossible, maybe.

I know you're looking for yes/no answers, but there's just no getting around the uncertainty.

$50K/year tuition is a lot of money. You'll graduate with about $300K in debt, and it'll compound to $400K+ by the time you're done with a 4 year residency program. On a 10 year payment plan, that works out to about $4500/month in student loan payments. That's either a lot or a little depending on what specialty you wind up in and the state of the world 10 years from today.

If you do HPSP and it turns out the Navy isn't for you, well, there are worse things in life than the GMO-&-out path that puts you into a civilian residency, debt free but 4 years older.

 

[rckelly23]

High, before, unlikely but not impossible, maybe.

I know you're looking for yes/no answers, but there's just no getting around the uncertainty.

$50K/year tuition is a lot of money. You'll graduate with about $300K in debt, and it'll compound to $400K+ by the time you're done with a 4 year residency program. On a 10 year payment plan, that works out to about $4500/month in student loan payments. That's either a lot or a little depending on what specialty you wind up in and the state of the world 10 years from today.

If you do HPSP and it turns out the Navy isn't for you, well, there are worse things in life than the GMO-&-out path that puts you into a civilian residency, debt free but 4 years older.

Could you give me more information about GMO tours? I'm pretty uninformed, and my HPSP recruiter hasn't mentioned it at all.

How long are the tours? Would I be away from family and loved ones? What are the daily activities of a GMO?

Thanks.

 

[Ziehl-Neelsen]

I'll be honest and admit that the financial concessions were a big motivation for me to pursue HPSP, especially since my program's tuition is around $46k. I worry about how long it would even take me to pay all of it back.

Depends on your specialty choice, how frugal you are, your willingness to arbitrage location for a higher salary, the status of federal reimbursement programs etc.

I'm going to do you a favor and point you to a website that will help you significantly in your monetary decisions and early career: http://whitecoatinvestor.com/

You can thank me later.

I'm sorry if posts like this have come up countless times before, but I want to make sure I am getting all the information I need in order to make an informed decision.

You are right. These questions have come up countless times before. Engross yourself in the forums, use the search function, and read the stickies. You will be able to answer virtually all your questions satisfactorily. When you get a greater familiarity with the milmed machine (it is clear you have a limited understanding), you can come back and ask specific questions.

I'll be honest and admit that the financial concessions were a big motivation for me to pursue HPSP, especially since my program's tuition is around $46k. I worry about how long it would even take me to pay all of it back.

But I am also really concerned about my obligation to the Navy, more so the unpredictability of it all.

If unpredictability concerns you, the military is not for you.

For those who have already accepted the HPSP, would you do it again?

Yes. But I am not you, and you are not me--as I am older and white and slightly less free. This is my theme for English B.

 

[pgg]

Could you give me more information about GMO tours? I'm pretty uninformed, and my HPSP recruiter hasn't mentioned it at all.

How long are the tours? Would I be away from family and loved ones? What are the daily activities of a GMO?

Many many threads here about GMO tours. Do a search. Spend some time reading - not minutes, not a couple hours, but multiple hours over multiple days.

The short version is that Navy GMO tours are usually 2 or 3 years, though you can do all 4 of your HPSP obligation as a GMO and get out, if you want. Your family can move with you to wherever the assignment is. If you are deployed overseas, they can't go with you. Navy GMO deployments are typically 7 months, but that is by no means set in stone. The job is mostly primary care for active duty servicemembers in your unit, with a fair bit of administrative work too.

The rabbit hole is far deeper. Read and if you have specific questions we can answer them. It's too hard for us to guess what you don't know, what you want to know, what you need to know, what you care about, etc.

 

[HighPriest]

Your dress uniforms are cooler, if that tips the scale in any way. At least, as an officer.

 

[pgg]

Yeah, the Navy officer blues are snazzy. That's counterbalanced by the bell bottoms they make the enlisted wear ... we're all about tradition in the Navy (no, not just rum, sodomy, and the lash!) but those costumes could stand a change.

 

[HMtoDO]

Depending on what residency you choose and how competitive it is will dictate when your GMO tour is. For all my docs who went EM and Anesthesia a GMO tour happened before residency. They were with the Marines as a Battalion Medical Officer, Flight surgeon, or DMO (Dive medical officer). all of the docs that wanted family med or internal medicine were able to complete residency prior to GMO tour.

Do not do the HPSP purely for monetary reasons. As someone who served enlisted active duty for 8 years in the medical field, you have to want to serve to enjoy it, and even then you will only enjoy it part of the time. The amount of hoops you have to jump through and BS that you have to wade through truly make it not worth it for the money you *think* you'll save.



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[SirGecko]

For all my docs who went EM and Anesthesia a GMO tour happened before residency. They were with the Marines as a Battalion Medical Officer, Flight surgeon, or DMO (Dive medical officer). all of the docs that wanted family med or internal medicine were able to complete residency prior to GMO tour.

This isn't exactly accurate. Nearly every specialty has a good chance of being forced to do a gmo tour prior to finishing residency. Even family and internal medicine. Some like ortho send probably the majority of their interns straight through and others (like say Radiology) take most of their PGY 2s from the fleet. In fact Emergency isn't even one of the ones that get most of their people from out in the fleet anymore as they instituted categorical internships a few years ago and seem to be taking a bunch of those straight through now. The point though is that it can change year to year so the assumption in the navy should be that you might need to do a gmo tour.

Also if it is after residency you aren't doing a GMO tour. At that point it's a utilization tour for whatever kind of doctor you have been trained to be. I have seen people get trained UMO or flight after finishing residency but that is usually for the more senior positions because they need them for the position but they don't already have the training. Much rarer (if ever? Can't say I've seen it) for a new board certified (or about to be board certified) physician to pick one of these jobs up.

 

[pgg]

Do not do the HPSP purely for monetary reasons. As someone who served enlisted active duty for 8 years in the medical field, you have to want to serve to enjoy it, and even then you will only enjoy it part of the time. The amount of hoops you have to jump through and BS that you have to wade through truly make it not worth it for the money you *think* you'll save.

I would have agreed with this wholeheartedly 5 or 10 years ago.

Now ... with student loans at 6.8% and some med schools charging $50K/year tuition (dont' forget the $20K/year other expenses) ... interest compounding during school and residency ... and physician reimbursement getting squeezed ...

The money isn't a bad reason to do it, if you think you won't mind serving and you can put up with some uncertainty in your life.

What's the bigger burden? 4 years as a GMO, or $400K of debt when you finish med school & residency?

The answer isn't obvious to me any more.

 

[HMtoDO]

This may be completely accurate now. I got out almost 2 years ago. But from my 8 years experience in the military and based off my interactions during that time that is what I personally learned. Times may be changing which could be a positive thing for the milmed crowd.

Either way, you should not consider an HPSP scholarship unless you have intentions to serve and not purely for the monetary incentive.

This isn't exactly accurate. Nearly every specialty has a good chance of being forced to do a gmo tour prior to finishing residency. Even family and internal medicine. Some like ortho send probably the majority of their interns straight through and others (like say Radiology) take most of their PGY 2s from the fleet. In fact Emergency isn't even one of the ones that get most of their people from out in the fleet anymore as they instituted categorical internships a few years ago and seem to be taking a bunch of those straight through now. The point though is that it can change year to year so the assumption in the navy should be that you might need to do a gmo tour.

Also if it is after residency you aren't doing a GMO tour. At that point it's a utilization tour for whatever kind of doctor you have been trained to be. I have seen people get trained UMO or flight after finishing residency but that is usually for the more senior positions because they need them for the position but they don't already have the training. Much rarer (if ever? Can't say I've seen it) for a new board certified (or about to be board certified) physician to pick one of these jobs up.

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[HMtoDO]

I would have agreed with this wholeheartedly 5 or 10 years ago.

Now ... with student loans at 6.8% and some med schools charging $50K/year tuition (dont' forget the $20K/year other expenses) ... interest compounding during school and residency ... and physician reimbursement getting squeezed ...

The money isn't a bad reason to do it, if you think you won't mind serving and you can put up with some uncertainty in your life.

What's the bigger burden? 4 years as a GMO, or $400K of debt when you finish med school & residency?

The answer isn't obvious to me any more.

True but the idea is that you wouldn't *mind* serving. This is to say that full consideration has been done and an informed decision made. That might be a better way to phrase what I am trying to say.


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[Gastrapathy]

@HMtoDO That wasn't accurate when you were in either. I did a GMO tour in-between IM training, as did many others. There is no such thing as a GMO tour after residency. You are, by definition, not a GMO. I know you can't tell the difference but those folks were doing "utilization tours" after residency.

 

[HMtoDO]

@HMtoDO That wasn't accurate when you were in either. I did a GMO tour in-between IM training, as did many others. There is no such thing as a GMO tour after residency. You are, by definition, not a GMO. I know you can't tell the difference but those folks were doing "utilization tours" after residency.

Very well. I think i may have confused them for the same. When I worked in the clinic none of my docs who went FM or IM had to do a GMO tour they went straight to residency and then on to their utilization tour. It makes sense now that I think about it. My experience with GMO was with the USMC Infantry. Had many different docs doing their tour there before they went on to GS, EM and Anesthesiology. Also met some other Anesthesiologists who went flight and dive for their GMO tour. none were able to go straight through but it also depends on the speciality and needs of the military at the time which is always a gamble too. Didn't mean to misinform anyone as it was not my intention! Thanks for the info too!


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[Setih]

To answer above and to anyone considering Navy HPSP, the recent classes have been Huge.

There is enough GMO backlog that most in every specialty including IM is not going straight through.
Unless you get straight through contract, there are some notably Ortho as noted above.

There are rumours that fellowships are going to the path of the Dodo.

I think in the upcoming cycles, straight thru seems even less likely.

...
I re-read above and sounds overly negative, not trying to be negative, but
One has to keep this in mind.
Also, uncertainty is a huge part of milmed, you go where you are told to go,
that's the service component and reason why they are giving this money to begin with.

 

[kpkb]

Could you give me more information about GMO tours? I'm pretty uninformed, and my HPSP recruiter hasn't mentioned it at all.

How long are the tours? Would I be away from family and loved ones? What are the daily activities of a GMO?

Thanks.

 

[kpkb]

GMO tours are 2 years and your family comes with you typically. Within those two years, you may be deployed for a month or possibly a few months, unaccompanied. Often you get some say in the matter, but not always.

 

[Gastrapathy]

GMO tours are 2 years and your family comes with you typically. Within those two years, you may be deployed for a month or possibly a few months, unaccompanied. Often you get some say in the matter, but not always.

WTF are you talking about? Deployed for a month? A month is TAD or workups. The wars have slowed down but even still, this is silly. If you include workups, I spent 13/26 months deployed and was forced to come back late to residency.

You only get a say in the matter if you use your uterus or fake PTSD to shift the opportunity to someone else. Why in the world would an O3 doc have a say in the plans of an operational unit. You're not Fat Leonard or SECDEF.

 

[navdoc47]

I think the awesome benefits of HPSP include:

1) you get to repeat intern year after you get out, making you less competitive as programs will prefer to select a candidate who doesn't have to repeat intern year

2) GMO is priceless - where else do you get an opportunity to learn how to work and get paid like a Physician Assistant for 4 years?

3) under HPSP you might be debt free sooner, but your civilian counterparts in specialties like anesthesia will be making $350K-$500K for every year of GMO land that you make $80-$100K per year.

 

[Atlas Shrugged]

GMO tours are 2 years and your family comes with you typically. Within those two years, you may be deployed for a month or possibly a few months, unaccompanied. Often you get some say in the matter, but not always.

A month long deployment? Do not give advice on topics you know nothing about.

 

[Cooperd0g]

A month long deployment? Do not give advice on topics you know nothing about.

Maybe he's AF. I'm can't even count the number of times I have heard AF people call anything away from garrison/home base a "deployment."

 

[IlDestriero]

Hey, I deployed to Coronado for 2 weeks for leadership training. I've got some time in the sand.


--
Il Destriero

 

[Eskibot]

Many many threads here about GMO tours. Do a search. Spend some time reading - not minutes, not a couple hours, but multiple hours over multiple days.

The short version is that Navy GMO tours are usually 2 or 3 years, though you can do all 4 of your HPSP obligation as a GMO and get out, if you want. Your family can move with you to wherever the assignment is. If you are deployed overseas, they can't go with you. Navy GMO deployments are typically 7 months, but that is by no means set in stone. The job is mostly primary care for active duty servicemembers in your unit, with a fair bit of administrative work too.

The rabbit hole is far deeper. Read and if you have specific questions we can answer them. It's too hard for us to guess what you don't know, what you want to know, what you need to know, what you care about, etc.

Depending on what residency you choose and how competitive it is will dictate when your GMO tour is. For all my docs who went EM and Anesthesia a GMO tour happened before residency. They were with the Marines as a Battalion Medical Officer, Flight surgeon, or DMO (Dive medical officer). all of the docs that wanted family med or internal medicine were able to complete residency prior to GMO tour.

Do not do the HPSP purely for monetary reasons. As someone who served enlisted active duty for 8 years in the medical field, you have to want to serve to enjoy it, and even then you will only enjoy it part of the time. The amount of hoops you have to jump through and BS that you have to wade through truly make it not worth it for the money you *think* you'll save.



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This isn't exactly accurate. Nearly every specialty has a good chance of being forced to do a gmo tour prior to finishing residency. Even family and internal medicine. Some like ortho send probably the majority of their interns straight through and others (like say Radiology) take most of their PGY 2s from the fleet. In fact Emergency isn't even one of the ones that get most of their people from out in the fleet anymore as they instituted categorical internships a few years ago and seem to be taking a bunch of those straight through now. The point though is that it can change year to year so the assumption in the navy should be that you might need to do a gmo tour.

Also if it is after residency you aren't doing a GMO tour. At that point it's a utilization tour for whatever kind of doctor you have been trained to be. I have seen people get trained UMO or flight after finishing residency but that is usually for the more senior positions because they need them for the position but they don't already have the training. Much rarer (if ever? Can't say I've seen it) for a new board certified (or about to be board certified) physician to pick one of these jobs up.

This may be completely accurate now. I got out almost 2 years ago. But from my 8 years experience in the military and based off my interactions during that time that is what I personally learned. Times may be changing which could be a positive thing for the milmed crowd.

Either way, you should not consider an HPSP scholarship unless you have intentions to serve and not purely for the monetary incentive.







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I think the awesome benefits of HPSP include:

1) you get to repeat intern year after you get out, making you less competitive as programs will prefer to select a candidate who doesn't have to repeat intern year

2) GMO is priceless - where else do you get an opportunity to learn how to work and get paid like a Physician Assistant for 4 years?

3) under HPSP you might be debt free sooner, but your civilian counterparts in specialties like anesthesia will be making $350K-$500K for every year of GMO land that you make $80-$100K per year.

How did you guys feel about doing the GMO tour if you completed it before? I know things will change (saying that because Im not even in med school yet but I just want as much information as possible) , but I want to match into a gen surg residency. With that said, I am still intrested in becoming a DMO if placed on a GMO tour, which I have heard from alot of places that in the Navy is very common. So if that is the case, i'll finish my intern year in whatever residency I end up matching, do a GMO tour, go back to the residency, then become and attending?

How hard is it to get "motivating" slots such as dive doc or flight surgeon?


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[SirGecko]

How did you guys feel about doing the GMO tour if you completed it before? I know things will change (saying that because Im not even in med school yet but I just want as much information as possible) , but I want to match into a gen surg residency. With that said, I am still intrested in becoming a DMO if placed on a GMO tour, which I have heard from alot of places that in the Navy is very common. So if that is the case, i'll finish my intern year in whatever residency I end up matching, do a GMO tour, go back to the residency, then become and attending?

How hard is it to get "motivating" slots such as dive doc or flight surgeon?


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Not sure what you mean by the first question as it's a little vague. Is there a specific aspect of GMO tours that you are trying to ask about or do you just mean in general? If you look in this forum you will find a lot of discussion about the utility of GMO's and some debate about what the military should be doing. Specifically you might want to check out the top thread in the stickies as it had some recent discussion about the appropriateness of GMO's if that is what you are looking for.

As for your second question: yes if you don't get selected to go straight through your residency that is roughly how it would work. In the first half of intern year you apply for GME2 spots (residency) as well as flight/dive. The match results come out in December. If you don't get a GME2 spot in the match you need to do some flavor of GMO tour. This could mean just calling the detailer and getting orders to one of the locations that doesn't require UMO or flight training. If you applied for UMO or flight at the same time as GME2 they release match results at the same time. If you are a reasonable candidate and interested in UMO or flight you will likely be able to do one of those assuming you are physically qualified for them. After you have been out doing your GMO work for usually at least two years you can apply again for a residency spot. It is important to realize this is an application though, not just returning to a residency. They could decide not select you for what you want and you wind up needing to do another GMO tour. (and just being a good candidate isn't necessarily protection against this, if you decide to go into something the navy decides they don't want more of no amount of awesome on your part is going to create a job for you to fill) Eventually though you will need to return to a residency either in the military or finish out your obligation to the military and apply for the civilian match.

 

[Perrotfish]

How did you guys feel about doing the GMO tour if you completed it before? I know things will change (saying that because Im not even in med school yet but I just want as much information as possible) , but I want to match into a gen surg residency. With that said, I am still intrested in becoming a DMO if placed on a GMO tour, which I have heard from alot of places that in the Navy is very common. So if that is the case, i'll finish my intern year in whatever residency I end up matching, do a GMO tour, go back to the residency, then become and attending?

How hard is it to get "motivating" slots such as dive doc or flight surgeon?

1) You have to apply for a Flight or Dive Spot, since there is a 6 month school associated with each before you are allowed to start working. Dive rarely has more applicants than slots and flight never does. A normal GMO tour is 2 years, while flight and dive are 3 (including the school), so the price you pay for the motivating billet is more time before you complete residency.

2) You apply to intern year and rest of residency separately. So if you match into a GenSurg intern year, then halfway through the year you apply to continue training. If you aren't selected to continue training you do a GMO tour. You can apply for flight and continued training at the same time.

3) When you are finishing your GMO tour, you apply to return to residency. It is an application, they don't have to take you. If they don't take you then you get another GMO tour. If you do enough GMO tours to run out your obligation then you can get out and apply to the civilian match.

4) Finally, you need to understand that the length of time you owe to the military coming out of residency is either what you owed going in, or the length of your residency, whichever is more. This means that, if you do a longer residency (like Surgery) after a GMO tour then the GMO tour effectively extends your obligation to the military. If you train straight through in surgery after the HPSP fellowship you went in owing 4 years, did an intern year + 4 year residency, and come out owing 4 years. If you go residency after a GMO tour you go in owing 2 years, but the residency is 4 years long, so you come out owing 4 years.

 

[pgg]

How did you guys feel about doing the GMO tour if you completed it before?

I can't give justice to my thoughts on it in less than 1000 words, but to sum up -

I was a Marine GMO with an infantry battalion. I enjoyed it at the time. I look back with basically happy memories.

It was an unwelcome (though not unexpected) professional delay. The delay cost me a great deal of money in lost specialty pay and board cert pay, and meant I had to spend 3 years doing primary care and administrative work instead of my desired specialty.

It is, IMO, a professional risk to be a glorified intern practicing medicine without supervision. The military has decided this risk is acceptable, but GMOs and patients are the ones who actually bear that risk. My opinion is that 100% of physicians practicing medicine for the fleet should be residency trained.

Your assignment, command climate, deployment destination/duration/timing, availability of professional backup from residency-trained physicians outside your unit, quality of support from within your unit, and 100 other factors are difficult to predict. I had a good experience with all of those things.


It's like all things in life. You buy your ticket and you take your chances.

 

[backrow]

Dive rarely has more applicants than slots and flight never does.

Not always the case. Both of these groups always have significant alternate lists and even some who are not selected. Usually dive is slightly tougher than flight due to number of slots available (also has fewer applicants though). The vast majority will get flight or dive if they apply; however, there is usually one or two (who aren't necessarily bad applicants) who get left out.


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[psu228]

Hi y'all, I was recently accepted to an osteopathic program and I am almost complete with my application for the Navy HPSP, but I am starting to seriously have doubts about whether I would want to accept it.

I'll be honest and admit that the financial concessions were a big motivation for me to pursue HPSP, especially since my program's tuition is around $46k. I worry about how long it would even take me to pay all of it back.

But I am also really concerned about my obligation to the Navy, more so the unpredictability of it all. What are the changes I would be required to serve a GMO tour? Would it happen before or after residency? Would I have a say in wanting to join a civilian residency? For those who have already accepted the HPSP, would you do it again?

I'm sorry if posts like this have come up countless times before, but I want to make sure I am getting all the information I need in order to make an informed decision. I am currently 24, and within the next 10 years or so I want to settle down, start having a family, and be able to practice medicine freely, but I worry the military would hamper these goals.

Thank you in advance for the insight.

Yea truthfully man it is only four years of your life, and you will have veterans benefits, pride of serving, etc.

The advice I was given by an Air Force major (who joined during residency, also a viable option if you are unsure if you can commit now) is to assume the worst when you get into the military. By that I mean assume that you will get a GMO tour you don't want, be on a base you don't want, etc. If you go in with a pragmatic maybe even pessimistic outlook but still think it's something you could end up doing, then you probably would be good for it. But doing go in hoping things will break how you want them to all the time. Sometimes that is the case but ultimately the Navy does what it wants and you are signing away everything up to and including your life for that period of time.

Either way, congrats on your acceptance to med school.

 

[SansaStarkMD]

If you don't want to be in the military don't join the military. Being owned by someone will impact your happiness much more than being poor worst case.

"Hey you, go live here for a year."

Etc.