How do army HPSP students get civilian residencies?

[cincityghost]

How would I go about applying for a civilian residency as an HPSPer. I would like to do EM, then maybe radiology (but not near as much as EM). Therefore, the army has three real potential spots I care for. With the reputation of the military match process, I'm afraid I may not end up anywhere I would like. How does this work?

Would I apply for the three army EM spots, then two radiology, and if I don't get any of them, I then apply for a civilian residency or jump in the scramble somehow. (I'm not too familiar with this b/c I'm only a second year right now.) When you are applying army, do you then fill in spots as civlian as part of your five choices? Also, am i right in that there only five spots you can apply for when appyling for army residency? Can an army HPSPer apply for civilian residency and army at the same time so that if army does not work out, the army HPSPer isn't scerwed into a GMO, FP, or IM? Lastly, when in the year do HPSP students match compared to civilian students?

Please clue me in with whatever info you can offer.

Thanks.

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[texdrake]

How would I go about applying for a civilian residency as an HPSPer. I would like to do EM, then maybe radiology (but not near as much as EM). Therefore, the army has three real potential spots I care for. With the reputation of the military match process, I'm afraid I may not end up anywhere I would like. How does this work?

Would I apply for the three army EM spots, then two radiology, and if I don't get any of them, I then apply for a civilian residency or jump in the scramble somehow. (I'm not too familiar with this b/c I'm only a second year right now.) When you are applying army, do you then fill in spots as civlian as part of your five choices? Also, am i right in that there only five spots you can apply for when appyling for army residency? Can an army HPSPer apply for civilian residency and army at the same time so that if army does not work out, the army HPSPer isn't scerwed into a GMO, FP, or IM? Lastly, when in the year do HPSP students match compared to civilian students?

Please clue me in with whatever info you can offer.

Thanks.

You MUST apply for every program in your top specialty. So if you pick ER you must apply to all military ER programs (of course you dont' have to interview with them). If you apply to a program with less than 5 locations (pediatrics in my case has four), then you can select any other spot to fill in the minimum of 5 programs. If you select ER and their is an ER spot available you will get it. That being said, most people get their first or second choice. Those that don't tend to be ones who want a deferment and try to play the system.

Also the Army is trying very hard to not force internship years on anyone that doesn't want one. They would rather give you a deferment in most cases. Of course if you select a traditional internship year as one of your top 3 choices you will most surely receive it.

 

[cincityghost]

You MUST apply for every program in your top specialty. So if you pick ER you must apply to all military ER programs (of course you dont' have to interview with them). If you apply to a program with less than 5 locations (pediatrics in my case has four), then you can select any other spot to fill in the minimum of 5 programs. If you select ER and their is an ER spot available you will get it. That being said, most people get their first or second choice. Those that don't tend to be ones who want a deferment and try to play the system.

Also the Army is trying very hard to not force internship years on anyone that doesn't want one. They would rather give you a deferment in most cases. Of course if you select a traditional internship year as one of your top 3 choices you will most surely receive it.

Thanks for the reply tex.

do you know if military interviews tend to be in person or via telephone (or either one)? how does that go?

 

[texdrake]

Thanks for the reply tex.

do you know if military interviews tend to be in person or via telephone (or either one)? how does that go?

I interviewed in person while on rotation at the locations I was looking at. I also have an interview in San Antonio setup in a week or two that I am doing in person because I will be in the area. I chose not to interview with DC because I don't want to go there. If it were a possibility for me I would try to phone interview, but really I would rather have a deferrment than go there.

Its really up to you. In person is better than a call, but a call is better than no interview. This is how it has been explained to me:

They select in the following order:

Rotated with them and Interviewed
Interviewed in person
Interviewed on the phone
No interview = very little chance of getting a spot

 

[colbgw02]

Additionally, if your specialty choice doesn't have 5 programs, I believe that the Army wants you to list transitional internships to fill the balance. Besides, for example, if you list all the ENT programs and then general surgery programs as your remaining spots and don't get ENT, I doubt very seriously that you would end up in surgery, but that's just what I've gleaned from this whole mess.

To echo above: I originally thought as you did - that I had very little chance of matching where I wanted. I did a 4-week rotation at the program I thought would be my number one choice, just hoping they would let me in. It turns out that as long as you're a halfway decent candidate, your chances of going to your top choice are great and it's nearly a lock to get one of your top two. If you are a good candidate, you can basically just choose your place. Also, the interview process outlined above is actually a very common formula, although I chose to at least interview in person with all of my specialty's programs. I'm glad I did that though, because my rank-order list actually changed after visiting a couple of the programs.

To answer some of your other questions...

As an HPSP student, you are required by the Army to apply to at least a few civilian programs through the normal ERAS/NRMP process. You complete a quasi-separate match process for the Army, the results of which you learn on December 15th. If you've been picked up by the Army (and you will, in all likelihood), you are then required to withdraw from the civilian match process. In theory, this is a good thing because - as mentioned before - it's designed to prevent you from doing an internship with the Army and then having to serve as a GMO for a few years. However, and this is purely grapevine stuff, I've been told that the Army is so hurting for docs of any sort right now that there won't be any deferments into civilian programs this year. What makes that all practically moot is that 85-90% match with the Army. That turns out to be a bit of a pain in the butt because you still have to go through the cost and bother of applying to civilian programs knowing full well that you'll be at an Army program, but c'est la vie. My suggestion is to do what I'm doing right now - schedule all your civilian interviews after December 15th and then promptly cancel them after officially hearing from the Army. In any case, the only real hope you have for doing a civilian residency is if 1) you're so ate up the Army doesn't want you, or 2) personal circumstances (i.e. your wife has cancer and doesn't want to leave her oncologist). You could try to "play the system" and, for instance, apply to the one Army neurosurgery spot assuming you won't get it and then concurrently apply to civilian programs of your choice hoping for a deferment. That's really messing with fire though with all sorts of places for things to go wrong.

I would caution you about hoping to do rads (my chosen profession) after emergency medicine. Once upon a time, that was no problem; tons of folks did second residencies, especially radiology. Nowadays, 16 out of 20 rads slots each year are earmarked specifically for senior medical students. The remaining 4 positions are competed for by unmatched interns, GMOs, and folks trying to do 2nd residencies. Basically, a lot more people trying to get a lot fewer number of slots. Also, civilian residency kinda frown on folks going back to radiology for a 2nd career, especially right now because rads is competitive enough that they don't have to worry about filling their slots, so I'm not really sure if that's an option right now. Who knows though, that could change in a few years.

Hope this helps......

 

[cincityghost]

Additionally, if your specialty choice doesn't have 5 programs, I believe that the Army wants you to list transitional internships to fill the balance. Besides, for example, if you list all the ENT programs and then general surgery programs as your remaining spots and don't get ENT, I doubt very seriously that you would end up in surgery, but that's just what I've gleaned from this whole mess.

To echo above: I originally thought as you did - that I had very little chance of matching where I wanted. I did a 4-week rotation at the program I thought would be my number one choice, just hoping they would let me in. It turns out that as long as you're a halfway decent candidate, your chances of going to your top choice are great and it's nearly a lock to get one of your top two. If you are a good candidate, you can basically just choose your place. Also, the interview process outlined above is actually a very common formula, although I chose to at least interview in person with all of my specialty's programs. I'm glad I did that though, because my rank-order list actually changed after visiting a couple of the programs.

To answer some of your other questions...

As an HPSP student, you are required by the Army to apply to at least a few civilian programs through the normal ERAS/NRMP process. You complete a quasi-separate match process for the Army, the results of which you learn on December 15th. If you've been picked up by the Army (and you will, in all likelihood), you are then required to withdraw from the civilian match process. In theory, this is a good thing because - as mentioned before - it's designed to prevent you from doing an internship with the Army and then having to serve as a GMO for a few years. However, and this is purely grapevine stuff, I've been told that the Army is so hurting for docs of any sort right now that there won't be any deferments into civilian programs this year. What makes that all practically moot is that 85-90% match with the Army. That turns out to be a bit of a pain in the butt because you still have to go through the cost and bother of applying to civilian programs knowing full well that you'll be at an Army program, but c'est la vie. My suggestion is to do what I'm doing right now - schedule all your civilian interviews after December 15th and then promptly cancel them after officially hearing from the Army. In any case, the only real hope you have for doing a civilian residency is if 1) you're so ate up the Army doesn't want you, or 2) personal circumstances (i.e. your wife has cancer and doesn't want to leave her oncologist). You could try to "play the system" and, for instance, apply to the one Army neurosurgery spot assuming you won't get it and then concurrently apply to civilian programs of your choice hoping for a deferment. That's really messing with fire though with all sorts of places for things to go wrong.

I would caution you about hoping to do rads (my chosen profession) after emergency medicine. Once upon a time, that was no problem; tons of folks did second residencies, especially radiology. Nowadays, 16 out of 20 rads slots each year are earmarked specifically for senior medical students. The remaining 4 positions are competed for by unmatched interns, GMOs, and folks trying to do 2nd residencies. Basically, a lot more people trying to get a lot fewer number of slots. Also, civilian residency kinda frown on folks going back to radiology for a 2nd career, especially right now because rads is competitive enough that they don't have to worry about filling their slots, so I'm not really sure if that's an option right now. Who knows though, that could change in a few years.

Hope this helps......

helps a ton. thanks. it's kind of nice to think i have a good shot of doing what i choose.

i think you misunderstood the rads comment. i just meant it was what i would do if I couldn't do ER. still thinking about it instead of ER at times though.

it really blows that you have to fill those extra spots with intership positions. are there any excetions to that. there's no way i could scatter derm, rads, and er among my 5 match rankings?

It sounds as if you are saying its easier to match in a military residency. Would it be significantly easier to end up in something like derm in the army as well? (compared to civilian) Do you have any idea if the applicants for derm in the army are as competitive as they are for civilian. i saw on mods that the ratio of applicants to spots last year was 1.2 to 1, which i speculate is probably better than civilian. if you can't tell, i've just got a thing for those lifestyle jobs.

write back if you get chance.

thanks

 

[colbgw02]

yeah, i did misunderstand about ER vs. rads. but army rads is still competitive enough that you're unlikely to match if they know your first choice is ER. you'd have to be careful about really selling your love of radiology to the rads folks and your love of ER medicine to those folks. not impossible, but remember that army medicine is a small family.

regarding internship, the letter of instruction only says, "You are required to rank all advertised Army training locations associated with your specialty goal for the FYGME match; these must be the same Army programs designated in MyERAS. In specialties with fewer than five Army programs, you must rank a minimum of five Army programs; your first rankings should agree with your specialty goal and the balance of your list should be made up of programs that can be considered as preliminary training such as the transitional year." My guess is that they'd nix any attempt to do other than above as soon as they found out about it.

yeah, i've got a thing lifestyle too, but i'd do rads even if it were as hard as ortho. in general, yes, it is easier to get into competitive residencies in the army. even in the army though, derm can be incredibly competitive. in certain cases, like with neurosurgery or physical medicine/rehabilitation, it's actually tougher in the army because there are so few spots. apart from that, it really varies year to year. i know for the class of 2005, something like only 12 people applied for radiology, which caused an influx of radiology applications. if that 1.2:1 ratio goes back a few years, then that's obviously more reliable 'cause it demonstrates a trend. also, army program directors are often pretty good about giving you an honest assessment of your competitiveness.