Navy HPSP Experience

[frimmyfrim]

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Hi Everyone!

I was wondering if I could get so me more perspective on experience in HPSP in the Navy. I am Starting the process and talking to recruiters but really want some more perspectives on residency, and then afterwards. Ive talked to quite a few people in military medicine (I work in military medical research currently and my supervisor did HPSP back in the day), but could really use a woman's perspective too. I'm also curious to see if people think there are adv/disadvantages to GMO or if it is better to do a residency if you can then do your "payback" years. I bet something like this already exists and I'm sorry if it does but thanks in advance for the perspectives and experiences.

 

[j4pac]

Welcome to the forum!

I would start by going to google and typing "HPSP SDN". You will probably get a thousands of opinions in hundreds of threads. But you are on the right track...become as educated as possible before signing anything.

In regards to payback...it depends what you sign up for. If you sign up for 4 years...it will be 4 years (not including residency) or however long it takes for you to complete residency. If you sign up for 3 years...it is the same as above....3 year payback unless your residency is longer.

Example 1: You do your internship and go directly into OB/GYN. That's a 4 year process...so your payback after residency is 4 years.

Example 2: You do your internship and go into GMO. You complete 4-years of GMO. You have no completed your payback.

Example 3: You do your internship and go into GMO. You do two years as a GMO, then match into OB/GYN. You then complete a 3 year OB/GYN residency. You now have to pay back 3-years. Realize that your total commitment not including residency was 5 years, and not the 4 years you agreed to.

Please someone correct me if I'm wrong about this.

 

[pawprint]

Example 3: You do your internship and go into GMO. You do two years as a GMO, then match into OB/GYN. You then complete a 3 year OB/GYN residency. You now have to pay back 3-years. Realize that your total commitment not including residency was 5 years, and not the 4 years you agreed to.

Please someone correct me if I'm wrong about this.

You are correct they owe 3 years after but its because:

You owe 4 years from medical school.
You pay back the 4 years as soon as you graduate (whether its serving as an intern, a GMO, or in a military residency, it doesn't matter)
Once you start a residency, you begin owing more time for each year in residency (even though you are paying back HPSP time as you are a resident)
Once you finish residency, you begin paying back residency time.

So for your example 3, once you have done your internship and 2 years of GMO, you have paid off 3 out of 4 of your HPSP years. You finish your HPSP 4th year of commitment while in your 1st year of OB/GYN residency. However, military residencies require you to pay back year for year of your residency, so a 3 year residency means once you finish the residency program, you owe 3 years.

 

[j4pac]

You are correct they owe 3 years after but its because:

You owe 4 years from medical school.
You pay back the 4 years as soon as you graduate (whether its serving as an intern, a GMO, or in a military residency, it doesn't matter)
Once you start a residency, you begin owing more time for each year in residency (even though you are paying back HPSP time as you are a resident)
Once you finish residency, you begin paying back residency time.

So for your example 3, once you have done your internship and 2 years of GMO, you have paid off 3 out of 4 of your HPSP years. You finish your HPSP 4th year of commitment while in your 1st year of OB/GYN residency. However, military residencies require you to pay back year for year of your residency, so a 3 year residency means once you finish the residency program, you owe 3 years.

That's what I meant to say, but you articulated it much better.

 

[TurtleDO2012]

Intern year is neutral in terms of pay back or increasing your ADSO. Then during residency you pay back a medschool year while also adding a year for residency.

So in example 3 you complete intern year, 2 years of GMO and start OBGYN residency you will have paid back the 4 years of med school at the end of the 2nd year of OBGYN residency and then at the end of the residency pay back for each year of training. They likely would make you start as a PGY-1 again in OBGYN unless your intern year was in OBGYN. So if starting at the beginning again you would have 4 years of payback.

As another example- you do a TY year for intern year, pay back 2 years as a GMO, start ER residency. You will owe 3 years after ER residency. You won't have any IRR time after leaving military since you did 9 years of active duty service.

Also if a program gives you say 6 months of credit towards their residency you will still owe an entire year of payback after residency is over- just the way the DOD rounds things up. You would though finish residency still early.

Another example- 4 year scholarship: intern IM year, 2 years of GMO, then return to IM- you would owe 2 years after residency because 2 years of GMO, 2 year residency pay back med school, but 2 year residency needs to be paid back so 2 more to go.

Another example- 4 year scholarship: IM residency- 4 years of payback, last 2 years of residency pay off 2 from scholarship, then 2 for residency and 2 for medical school so total of 4 left to payback.

 

[pawprint]

I didn't know intern year was a neutral year, it makes sense though since you need to have finished an internship to be officially useful.

So to clarify, you can't do an internship and then a 3 year GMO (such as flight surgery) to pay back all your time from a 4 year scholarship? You would need to do two 2 year GMO tours after your intern year if you wanted out before residency?

 

[Red Lobster Actual]

I didn't know intern year was a neutral year, it makes sense though since you need to have finished an internship to be officially useful.

So to clarify, you can't do an internship and then a 3 year GMO (such as flight surgery) to pay back all your time from a 4 year scholarship? You would need to do two 2 year GMO tours after your intern year if you wanted out before residency?

If you want to do GMO to fully pay back your time you must do it for 4 years since intern year doesn't count. However, it is entirely possible to do 4 years on a single billet.

 

[afteranesthesia]

Here's a question - what if you have the four year hpsp, do a four year residency - then a civ sponsored fellowship that is one year. Technically since intern year is neutral, I should have another year I could train since I got the four year hpsp. Can I apply that year to what's owed back from fellowship thus owing only one extra year ( since sponsored slots incur a 2:1 payback)?

 

[colbgw02]

You are not paying back any time while in residency. This is a commonly held, but inaccurate, belief. Heck, I went years thinking it was true and even repeated it many times on this forum before being set straight. The misunderstanding persists, in part, because the math works out the same for the overwhelming number of people.

 

[j4pac]

Intern year is neutral in terms of pay back or increasing your ADSO. Then during residency you pay back a medschool year while also adding a year for residency.

So in example 3 you complete intern year, 2 years of GMO and start OBGYN residency you will have paid back the 4 years of med school at the end of the 2nd year of OBGYN residency and then at the end of the residency pay back for each year of training. They likely would make you start as a PGY-1 again in OBGYN unless your intern year was in OBGYN. So if starting at the beginning again you would have 4 years of payback.

As another example- you do a TY year for intern year, pay back 2 years as a GMO, start ER residency. You will owe 3 years after ER residency. You won't have any IRR time after leaving military since you did 9 years of active duty service.

Also if a program gives you say 6 months of credit towards their residency you will still owe an entire year of payback after residency is over- just the way the DOD rounds things up. You would though finish residency still early.

Another example- 4 year scholarship: intern IM year, 2 years of GMO, then return to IM- you would owe 2 years after residency because 2 years of GMO, 2 year residency pay back med school, but 2 year residency needs to be paid back so 2 more to go.

Another example- 4 year scholarship: IM residency- 4 years of payback, last 2 years of residency pay off 2 from scholarship, then 2 for residency and 2 for medical school so total of 4 left to payback.

I didn't know that internship was seen as neutral.

How about this example: 4 year payback. Perform transitional internship. Perform 2 year GMO. Perform 5 year Gen Surg residency (because they would likely make re-do internship). Does that mean that since internship is neutral, that you would only own 4 years after completing your Gen Surg residency? I thought that the for the 4-yr HPSP contract that you own 4-years or more if your residency is longer than 4 years. So even though you paid back 2 years as a GMO, that doesn't matter because you now have to pay back the Gen Surg residency.

 

[afteranesthesia]

Sorry I wasnt clear. I'm def not paying back time now while in residency and I know that bc I'm civ deferred. I will pay it back as an attending. I'm asking that since intern year is neutral and my residency apart from intern year is three years and I owe four years from taking the full scholarship this not owing any extra unless I supersede four in residency- can I apply one of those years towards training in a civ sponsored fellowship spot owing only one year extra after fellowship instead of two years extra bc sponsored is a two for one pay back? Does that make sense?

 

[j4pac]

Sorry I wasnt clear. I'm def not paying back time now while in residency and I know that bc I'm civ deferred. I will pay it back as an attending. I'm asking that since intern year is neutral and my residency apart from intern year is three years and I owe four years from taking the full scholarship this not owing any extra unless I supersede four in residency- can I apply one of those years towards training in a civ sponsored fellowship spot owing only one year extra after fellowship instead of two years extra bc sponsored is a two for one pay back? Does that make sense?

I highly doubt it. They will likely considering it training...and therefore it won't count toward your payback. Not a 100% sure about this one, and I am sure that there is someone on this forum who has performed a fellowship while in the military and will give you better advice.

 

[frimmyfrim]

This has all been really helpful. The payback part is the hardest to comprehend considering there are so many different paths to take.

I knew intern was a neutral year but I also remember reading something I swear that even if you do a 5 yr residency you may only have to serve ad four years - I have no idea if that's actually true but thought I'd troe it out there in case someone else has heard that too.

 

[colbgw02]

Sorry I wasnt clear. I'm def not paying back time now while in residency and I know that bc I'm civ deferred. I will pay it back as an attending. I'm asking that since intern year is neutral and my residency apart from intern year is three years and I owe four years from taking the full scholarship this not owing any extra unless I supersede four in residency- can I apply one of those years towards training in a civ sponsored fellowship spot owing only one year extra after fellowship instead of two years extra bc sponsored is a two for one pay back? Does that make sense?

The 'baseline' rules suggest that you could do this. To wit, owe 4 years from HPSP, owe 5 years from GME (residency + fellowship), and then pay those back concurrently for a total of a 5 year post-training obligation. The problem is that they add specific language to your fellowship contract stating that the accompanying obligation is tacked onto the end of all existing commitments.

 

[colbgw02]

I didn't know that internship was seen as neutral.

How about this example: 4 year payback. Perform transitional internship. Perform 2 year GMO. Perform 5 year Gen Surg residency (because they would likely make re-do internship). Does that mean that since internship is neutral, that you would only own 4 years after completing your Gen Surg residency? I thought that the for the 4-yr HPSP contract that you own 4-years or more if your residency is longer than 4 years. So even though you paid back 2 years as a GMO, that doesn't matter because you now have to pay back the Gen Surg residency.

Correct. You would finish residency with two remaining years of HPSP obligation and four years (assuming no research year) of GME obligation. Those are paid off concurrently for a total of a 4-year post-residency obligation.

 

[IlDestriero]

Here's a question - what if you have the four year hpsp, do a four year residency - then a civ sponsored fellowship that is one year. Technically since intern year is neutral, I should have another year I could train since I got the four year hpsp. Can I apply that year to what's owed back from fellowship thus owing only one extra year ( since sponsored slots incur a 2:1 payback)?

If you did a one year internship and were selected for a 3 year military residency (like anesthesia for example) when you finished the military residency you would still owe 4 years. If you picked up a 1 year military sponsored fellowship, you would owe 2 more years, for a total of 6 in uniform, before your commitment was up.

 

[TurtleDO2012]

Getting into specific weeds now-

Most everyone will take the oath for AD service at medical school graduation or at your first duty station. This would be your entry onto active duty date and is typically found on ORB or LES.
There is typically a gap of time from that date and actually starting intern year July 1.

So my question- If an individual is a GMO with only intern year completed and their 4 yr schloarship to pay back and doesn't have any other pre-existing ADSOs from the ASP contract (doesn't take it their final year) or PCS move adso (has fullfilled the minimal requirement at current billet and extends to last AD day) would their final day listed on the LES/OER plus 5 years be the last day in the military? Then use that day to work backwards with whatever accrued leave to separate at the earliest?

Or is the final day tied to completing intern year? Depending on the interpretation of the rules I could have a final day in early May if I don't take the ASP vs in July if taking ASP.

Corrected to ASP instead of MSP

 

[colbgw02]

I think you mean the (M)ASP contract. MSP is what residency-trained people sign after their ADSO is fulfilled or they've reached 8 years of MC service.

To answer your question though, I think the critical piece of information is whether or not that period of time (beginning of active duty to 1 July), is considered part of internship. My suspicion is that it is, and therefore would not contribute to your payback, but I don't have a regulation to cite.

 

[TurtleDO2012]

Correct- it is ASP.

 

[brooklynMD]

You are correct they owe 3 years after but its because:

You owe 4 years from medical school.
You pay back the 4 years as soon as you graduate (whether its serving as an intern, a GMO, or in a military residency, it doesn't matter)
Once you start a residency, you begin owing more time for each year in residency (even though you are paying back HPSP time as you are a resident)
Once you finish residency, you begin paying back residency time.

So for your example 3, once you have done your internship and 2 years of GMO, you have paid off 3 out of 4 of your HPSP years. You finish your HPSP 4th year of commitment while in your 1st year of OB/GYN residency. However, military residencies require you to pay back year for year of your residency, so a 3 year residency means once you finish the residency program, you owe 3 years.

Is it possible to do a residency after HPSP at a non military hospital and then give the 4 years back after residency. For me, i want to do surgery which is a 5 year residency program. How would this work? could you please advise, thank you 🙂

 

[colbgw02]

Is it possible to do a residency after HPSP at a non military hospital and then give the 4 years back after residency. For me, i want to do surgery which is a 5 year residency program. How would this work? could you please advise, thank you 🙂

You're referring to deferment, which has highly variable degrees of likelihood based upon timing, specialty, and service.

Overall, it would be folly to commit to the military while relying on deferment. If you accept the military's money, do so planning to complete a military residency (unless you're willing to do GMO and out). If you happen to get your wish of a deferment, then consider yourself lucky.

 

[brooklynMD]

Sorry I wasnt clear. I'm def not paying back time now while in residency and I know that bc I'm civ deferred. I will pay it back as an attending. I'm asking that since intern year is neutral and my residency apart from intern year is three years and I owe four years from taking the full scholarship this not owing any extra unless I supersede four in residency- can I apply one of those years towards training in a civ sponsored fellowship spot owing only one year extra after fellowship instead of two years extra bc sponsored is a two for one pay back? Does that make sense?

Intern year is neutral in terms of pay back or increasing your ADSO. Then during residency you pay back a medschool year while also adding a year for residency.

So in example 3 you complete intern year, 2 years of GMO and start OBGYN residency you will have paid back the 4 years of med school at the end of the 2nd year of OBGYN residency and then at the end of the residency pay back for each year of training. They likely would make you start as a PGY-1 again in OBGYN unless your intern year was in OBGYN. So if starting at the beginning again you would have 4 years of payback.

As another example- you do a TY year for intern year, pay back 2 years as a GMO, start ER residency. You will owe 3 years after ER residency. You won't have any IRR time after leaving military since you did 9 years of active duty service.

Also if a program gives you say 6 months of credit towards their residency you will still owe an entire year of payback after residency is over- just the way the DOD rounds things up. You would though finish residency still early.

Another example- 4 year scholarship: intern IM year, 2 years of GMO, then return to IM- you would owe 2 years after residency because 2 years of GMO, 2 year residency pay back med school, but 2 year residency needs to be paid back so 2 more to go.

Another example- 4 year scholarship: IM residency- 4 years of payback, last 2 years of residency pay off 2 from scholarship, then 2 for residency and 2 for medical school so total of 4 left to payback.

Can you help with this: I want to do a surgical residency which is 5 years. Since the HPSP is 4 years payback how would that work? If i complete my 5 year surgical residency program elsewhere could i repay the 4 years after residency? and also, what is civ differed?

 

[brooklynMD]

w

You're referring to deferment, which has highly variable degrees of likelihood based upon timing, specialty, and service.

Overall, it would be folly to commit to the military while relying on deferment. If you accept the military's money, do so planning to complete a military residency (unless you're willing to do GMO and out). If you happen to get your wish of a deferment, then consider yourself lucky.

what does GMO and out mean exactly?

 

[brooklynMD]

You're referring to deferment, which has highly variable degrees of likelihood based upon timing, specialty, and service.

Overall, it would be folly to commit to the military while relying on deferment. If you accept the military's money, do so planning to complete a military residency (unless you're willing to do GMO and out). If you happen to get your wish of a deferment, then consider yourself lucky.

but how would a 5 year residency work? if its a year per year of residency, thats 10 years? This isn't adding up correctly to me
and what do you mean by GMO and out?

 

[colbgw02]

but how would a 5 year residency work? if its a year per year of residency, thats 10 years? This isn't adding up correctly to me

That's because you haven't done your due diligence with respect research.

 

[Red Lobster Actual]

@brooklynMD Google is your friend. Just type the abbreviation and add on "military" and then read.

As for the years you have to pay back just type in "obligation" in the search bar for this subforum and start reading.

And also, you're not a US citizen yet. While you are working on your naturalization, just read through this forum and learn as much as you can.

You absolutely CANNOT be an officer unless you are a US citizen. Therefore this is an absolute requirement for HPSP because one is commissioned as an officer. So until you taken the Oath of Citizenship and hold your Naturalization Certificate, Uncle Sam will not pay for your medical school.

 

[brooklynMD]

@brooklynMD Google is your friend. Just type the abbreviation and add on "military" and then read.

As for the years you have to pay back just type in "obligation" in the search bar for this subforum and start reading.

And also, you're not a US citizen yet. While you are working on your naturalization, just read through this forum and learn as much as you can.

You absolutely CANNOT be an officer unless you are a US citizen. Therefore this is an absolute requirement for HPSP because one is commissioned as an officer. So until you taken the Oath of Citizenship and hold your Naturalization Certificate, Uncle Sam will not pay for your medical school.

So im getting citizenship through army reserves. I get it before combat training begins in August, and that makes me eligible for the HPSP. So for now, its 10 weeks of bct and then 7 weeks of advanced training. I get my US nationality before this happens of course, and i am eligible for it being a green card holder. I am thinking of not going through with HPSP and just staying in the reserves. Do you have experience with being in reserves and in med school?

 

[Red Lobster Actual]

So im getting citizenship through army reserves. I get it before combat training begins in August, and that makes me eligible for the HPSP. So for now, its 10 weeks of bct and then 7 weeks of advanced training. I get my US nationality before this happens of course, and i am eligible for it being a green card holder. I am thinking of not going through with HPSP and just staying in the reserves. Do you have experience with being in reserves and in med school?

No experience with the reserves unfortunately. But...I know there are plenty of threads about reserves in medical school. The truth is here, just gotta find it 🙂

 

[LSDiVinci]

Hi @brooklynMD I've been in the Army for 8 years and am preparing to sign a new HPSP contract as I'm starting medical school in the fall. The best thing about switching over to the HPSP program is that it makes you non-deployable throughout medical school and you are not required to fulfill any type of drilling commitment once a month as you would with the Reserves. I know some people who are doing the HPSP with the Ohio National Guard and they still drill during the month, but they are not required to complete any tasks, only study. The biggest negative to staying in the Reserves while in medical school, and NOT switching over to an HPSP contract is that the Reserves can deploy you in the middle of school. You could file a hardship, but they can do what they want and deploy you anyway. In addition, though one weekend a month and two weeks over the summer sounds like a small amount of time, I was allowed to take medical physiology with NEOMED as part of my graduate degree and I can absolutely tell you that the one weekend a month always got in the way because I really needed that time to study. In addition, consider the two weeks over the summer that you'd be required to do in the reserves. Between M1 and M2 years this isn't such a big problem....but it will be a problem between M2 and M3 when you are trying to study and take the USMLE and/OR COMLEX. The army was great in helping me get to this point in my career and it made me stand out as an applicant for sure, but I highly recommend signing a HPSP contract when the time comes and not trying to continue with a regular contract. I hope this was helpful.