HPSP Questions

[brc1123]

Hi everyone,

I am a first year medical student and am on the fence about joining the 3 year Air Force HPSP program.

The financial benefit is not a huge concern for me and, in fact, I found that most civilian doctors typically make more money than members in the HPSP program in the long run.

A major pro is that I am interested in military medicine (in the short-term) and think it would be a great experience.

A major con, however, is that, although I am currently undecided, I am very focused on pursuing a medical specialty such as cardiology, neurology, etc. I also dislike the idea of having less personal freedom through the HPSP program.

With that being said, I was wondering if it is possible to join the 3 year HPSP program, then finish a civilian residency and fellowship in a medical specialty, then complete the 3 obligatory years as a specialized physician in the air force, and then leave the air force and return to a civilian job in that specialty without any time lost in training.
From what I read it seems that the military makes this linear situation rather difficult but I was wondering if anyone can speak personally about the probability of me being able to pursue these goals.

Any other comments about the HPSP program and military medicine would also be highly appreciated.

Thank you

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[BunnyMan17]

If you have a strict, utterly non-flexible timeline in mind then HPSP is probably not the best route for you. If you want something hard enough, you can usually get there in the military (DHA changes aside)..but... the path might be a little circuitous. Air force has the most civilian deferments of the branches. Some fellowships/specialist slots in the military are also in the process of being switched over to civilians, so that can theoretically limit your options.

The financial part varies depending on how much your school costs, time in service, and speciality. A lot of primary care docs actually come out ahead. Specialists, surgeons, etc. less so.

What do you mean by personal freedom? As in during med school or afterwards?

Also, just food for thought, you say you are interested in military medicine but your plan seems to include the bare minimum time wearing a uniform? No judgement but if you want that then maybe do Navy HPSP, then GMO for a few years, get out, and move on with civilian life.

 

[mrbreakfast]

The financial benefit is not a huge concern for me

Someone better versed in finances can probably clarify this, but to me, some quick math demonstrates the financial benefit of no loans + 3 years of military salary << the financial benefit of taking out loans, interest accruing through residency, + first 3 years of civilian practice.

Everyone in my med school class who did a military program did it because they wanted to serve in the military, and were willing to take a slight financial/career choice hit because of it.

 

[brc1123]

If you have a strict, utterly non-flexible timeline in mind then HPSP is probably not the best route for you. If you want something hard enough, you can usually get there in the military (DHA changes aside)..but... the path might be a little circuitous. Air force has the most civilian deferments of the branches. Some fellowships/specialist slots in the military are also in the process of being switched over to civilians, so that can theoretically limit your options.

The financial part varies depending on how much your school costs, time in service, and speciality. A lot of primary care docs actually come out ahead. Specialists, surgeons, etc. less so.

What do you mean by personal freedom? As in during med school or afterwards?

Also, just food for thought, you say you are interested in military medicine but your plan seems to include the bare minimum time wearing a uniform? No judgement but if you want that then maybe do Navy HPSP, then GMO for a few years, get out, and move on with civilian life.

Thanks for the reply.

When you state "air force has the most civilian deferments of the branches" does this mean that it would be the best option for me if I want to pursue a civilian residency and fellowship?

As for personal freedom, I was referring specifically to after medical school. I was trying to refer to the fact that the military has a large say in dictating where you go to residency, where you practice, what specialty you will be placed in, etc. At least that is how the blogs on student doctor network make it out to be. Please correct me if you think this is wrong.

On that note, I have another question about the HPSP program if anyone can answer it. Will joining the HPSP program have a large effect on where I can potentially be matched for residency. In other words, can the air force/army/navy prevent me from joining a civilian residency and prevent me from joining a subsequent specialty fellowship if they find that it will not be beneficial to their work force (that is, before my active duty and reserve time is completed). For example, say I wanted to join a 3 year civilian internal medicine program followed by a 2 year civilian cardiology fellowship directly after medical school. Can the air force/army/navy prevent me from joining a civilian internal medicine program and subsequently prevent me from joining a cardiology fellowship before I have served my active duty time if they choose to do so?

As for the bare minimum question:
I have always been interested in the military. I come from a military family (ending with my father) and have had brief exposures to the military that I really enjoyed. However, I have never really had a chance to join or really experience the military first hand. This is the main reason I am slightly hesitant to go all in at this point. As previously mentioned, I also have the goal of practicing as a specialized physician and would prefer to accomplish this goal sooner rather than later.
For these reasons, I am hoping to commit myself to a minimum amount of military service to get a feel for what it would be like and to understand if the military would be the right choice for me. If I don't like it I want to be able to back out quickly and if I do I will strongly consider staying longer. It seems that the military's minimum obligations are quite long though and I have yet to find one that would fit well with my agenda.

 

[brc1123]

Someone better versed in finances can probably clarify this, but to me, some quick math demonstrates the financial benefit of no loans + 3 years of military salary << the financial benefit of taking out loans, interest accruing through residency, + first 3 years of civilian practice.

Everyone in my med school class who did a military program did it because they wanted to serve in the military, and were willing to take a slight financial/career choice hit because of it.

Thank you for the comment.

I also am potentially interested in serving for the military as well, although I am clearly still undecided.
I would be willing to take a slight financial and career choice hit because of it but I am nervous that it will be more than just a slight hit considering my goals. I started medical school at 24 and will not be finished with an internal medicine residency program until I am 30. If I plan to specialize in electrophysiology (something I am currently interested in) it would take 4 more years and I would not be an independent physician until I am 34 years old. At that point I only have 30-40 more years of my career left.

Add the military program to this and I would potentially have to complete 3 years of internal medicine active duty for the military before I can specialize (assuming they won't let me specialize first). If I then start the 4 year electrophysiology specialization I would be 38 by the time I was finished which is pretty old to be starting your desired career in my opinion. In addition, with the 6 year (I think) military reserve obligation I believe I could potentially be deployed at anytime during my 4 year fellowship which would significantly disrupt my progress and extend the time it takes for me to start my career.

This is why I really want to make sure that if I join the military I would be able to pursue my desired career without having any significant time disruptions (eg civilian/military residency followed by a 4 year fellowship and then 3 years of active duty in my specialty followed by reserves).

 

[BunnyMan17]

Thank you for the comment.

I also am potentially interested in serving for the military as well, although I am clearly still undecided.
I would be willing to take a slight financial and career choice hit because of it but I am nervous that it will be more than just a slight hit considering my goals. I started medical school at 24 and will not be finished with an internal medicine residency program until I am 30. If I plan to specialize in electrophysiology (something I am currently interested in) it would take 4 more years and I would not be an independent physician until I am 34 years old. At that point I only have 30-40 more years of my career left.

Add the military program to this and I would potentially have to complete 3 years of internal medicine active duty for the military before I can specialize (assuming they won't let me specialize first). If I then start the 4 year electrophysiology specialization I would be 38 by the time I was finished which is pretty old to be starting your desired career in my opinion. In addition, with the 6 year (I think) military reserve obligation I believe I could potentially be deployed at anytime during my 4 year fellowship which would significantly disrupt my progress and extend the time it takes for me to start my career.

This is why I really want to make sure that if I join the military I would be able to pursue my desired career without having any significant time disruptions (eg civilian/military residency followed by a 4 year fellowship and then 3 years of active duty in my specialty followed by reserves).

You're gonna be 38 at some point no matter what, I have people in my classes that were not starting med school until almost 34. Definitely a factor, I agree, but it helps if you focus on the journey as well as the end goal. HPSP is a 4 year commitment, after that is IRR. Also see here: HPSP Fact Sheet
Someone else can double check me, but I've yet to meet a fellow who had been deployed during fellowship. Not that it can't happen though, anything's possible with Uncle Sam.

Thanks for the reply.

When you state "air force has the most civilian deferments of the branches" does this mean that it would be the best option for me if I want to pursue a civilian residency and fellowship?

More or less, although getting both civilian residency and civilian fellowship is less likely (not that it can't be done per say). There are a lot of things a medical officer does in addition to what a civilian doc would do. At the risk of being a broken record, google "operation bushmaster" for a little more insight. Note this is a USUHS things as opposed to HPSP but the idea behind the training's still there.
You can always look into direct ascensions and such. Essentially do all your civilian training then join, I believe the bonus here is ~400k w/ a 4 year commitment.

As for personal freedom, I was referring specifically to after medical school. I was trying to refer to the fact that the military has a large say in dictating where you go to residency, where you practice, what specialty you will be placed in, etc. At least that is how the blogs on student doctor network make it out to be. Please correct me if you think this is wrong.

That's correct. For the record while you may or may not get that pediatric oncology metabolic pacific sunfish neurosurgery spot, the vast majority of my attendings ended up where they wanted to be or are pleased with where they are. Again, just might be a more circuitous route.

On that note, I have another question about the HPSP program if anyone can answer it. Will joining the HPSP program have a large effect on where I can potentially be matched for residency. In other words, can the air force/army/navy prevent me from joining a civilian residency and prevent me from joining a subsequent specialty fellowship if they find that it will not be beneficial to their work force (that is, before my active duty and reserve time is completed). For example, say I wanted to join a 3 year civilian internal medicine program followed by a 2 year civilian cardiology fellowship directly after medical school. Can the air force/army/navy prevent me from joining a civilian internal medicine program and subsequently prevent me from joining a cardiology fellowship before I have served my active duty time if they choose to do so?

Yup, sorry, this is the military. Don't forget they have a broader purpose and it's called military service for a reason (not being snarky, I promise). In my world --> "needs of the navy always come first"
Why such a hardcore focus on doing a civilian vs. military residency and/or fellowship?

As for the bare minimum question:
I have always been interested in the military. I come from a military family (ending with my father) and have had brief exposures to the military that I really enjoyed. However, I have never really had a chance to join or really experience the military first hand. This is the main reason I am slightly hesitant to go all in at this point. As previously mentioned, I also have the goal of practicing as a specialized physician and would prefer to accomplish this goal sooner rather than later.
For these reasons, I am hoping to commit myself to a minimum amount of military service to get a feel for what it would be like and to understand if the military would be the right choice for me. If I don't like it I want to be able to back out quickly and if I do I will strongly consider staying longer. It seems that the military's minimum obligations are quite long though and I have yet to find one that would fit well with my agenda.

Is there a MTF near you? Civilian students can do rotations there. Otherwise, yes that is a fair point. It's a hard thing to understand unless you've been in and I understand your hesitation.
Real talk (and please don't take this offensively): You appear to be holding on very, very tightly to your goals and aspirations, otherwise eschewing commitment and any deviation from a very specific plan. There is nothing inherently wrong with this, you gotta look out for #1 and I hold no judgement. However, in the military you've gotta realize it's not about you. It's about that 20 yo marine PFC who was ambushed in an aid convoy and now wakes up with no legs, its the wife who's trying to understand gestational diabetes 1 week after her spouse is deployed and 1 month after they moved halfway across the country. It's about the 5 yo twins that will never see their father and the newly single parent desperately trying to make sense of it all, it's about that girl from the village in coastal Africa who's only hope for life is the Mercy or Comfort just showing over the horizon.
Romanticized or not, the military is a different world and does not fit everyone.

 

[mrbreakfast]

Rather than quote big blocks I'll just say this:

1) You are a first-year med student. You have zero idea what you'll want to do for your future career. Trust me, you've had zero exposure to 97% of medicine. Everyone changes their plans. Don't worry about it too much right now.

2) Man, I don't know about you but I'd MUCH rather do an active duty obligation when I'm younger than when I'm in my mid/late-30s.

3) I can summarize what you're saying as "I'd like to experience the military, but..." and listing a bunch of reasons why it won't be a good fit. As I said above, everyone I know who did military match were people who cared much more about serving their country than what fellowship they got into.

If you want to have a military connection, you can always work at a VA. An electrophysiologist would have plenty of work there.

 

[USAFDocAZ24]

I’ll add in my good ol’ 2 cents since I’m pretty passionate about this.

I’m a first year med student, 24 y/o, and Air Force HPSP. I haven’t attended COT or had much exposure to military service or life at this point. Similarly, I haven’t had much exposure to medicine at this point in medical school. So let’s commence my Ted Talk.

Financially, HPSP sounds like a good short term deal.... no debt (ideally), income in school, material reimbursement, and $20k bonus all sounds good until you crunch the numbers, especially if you’re attending an in-state school. You’re going to make a good living as a physician regardless of what specialty you get into, so joining HPSP because of finances is a piss poor motivation if you ask me.

I truly believe your happiness in a military setting will dependent on knowing what your personality is and matching it with a branch that fits your personality. Each branch has pros and cons and you need to be able to really do some thinking to see what fits best with your goals and what makes you happy. For example, coming from the desert, I do not spend much time on boats or ships. The idea of possibly being deployed to a carrier group just sounds miserable to me.... so sorry Navy.

For me, pride is a huge reason for me joining. I have many friends who have been in the service and have helped me tremendously. Being able to give back to that community instills a sense of pride and I feel it’s my duty. Sure I may hate being an Air Force doc, but what’s 4 years of AD service in the grand scheme of things? Not much. You gotta try something to know that you don’t like it. Just remember, at the end of the day, you are going to be a physician. You are going to help the community. It just depends on what community means the most to you, for me, it’s those that have signed a blank check to the good ol’ USofA.

 

[brc1123]

Yup, sorry, this is the military. Don't forget they have a broader purpose and it's called military service for a reason (not being snarky, I promise). In my world --> "needs of the navy always come first"
Why such a hardcore focus on doing a civilian vs. military residency and/or fellowship?

Not a hardcore focus just wanted to make sure I could still pursue a specific specialty I wanted.

Is there a MTF near you? Civilian students can do rotations there. Otherwise, yes that is a fair point. It's a hard thing to understand unless you've been in and I understand your hesitation.
Real talk (and please don't take this offensively): You appear to be holding on very, very tightly to your goals and aspirations, otherwise eschewing commitment and any deviation from a very specific plan. There is nothing inherently wrong with this, you gotta look out for #1 and I hold no judgement. However, in the military you've gotta realize it's not about you. It's about that 20 yo marine PFC who was ambushed in an aid convoy and now wakes up with no legs, its the wife who's trying to understand gestational diabetes 1 week after her spouse is deployed and 1 month after they moved halfway across the country. It's about the 5 yo twins that will never see their father and the newly single parent desperately trying to make sense of it all, it's about that girl from the village in coastal Africa who's only hope for life is the Mercy or Comfort just showing over the horizon.
Romanticized or not, the military is a different world and does not fit everyone.

Can you please explain what an MTF is?
No offense taken at all. That is very well said and thank you for taking the time to tell me that. I will definitely think really hard about if I want to join the military. I am just sometimes overly cautious about making big life decisions.

 

[brc1123]

Rather than quote big blocks I'll just say this:

1) You are a first-year med student. You have zero idea what you'll want to do for your future career. Trust me, you've had zero exposure to 97% of medicine. Everyone changes their plans. Don't worry about it too much right now.

2) Man, I don't know about you but I'd MUCH rather do an active duty obligation when I'm younger than when I'm in my mid/late-30s.

3) I can summarize what you're saying as "I'd like to experience the military, but..." and listing a bunch of reasons why it won't be a good fit. As I said above, everyone I know who did military match were people who cared much more about serving their country than what fellowship they got into.

If you want to have a military connection, you can always work at a VA. An electrophysiologist would have plenty of work there.

1) That is true but I would prefer to keep my options open if possible. It at least seems to me that signing up for the HPSP now could potentially limit my future options.

2) Good point

3) Please see my previous reply to BunnyMan ("I have always been interested in the military ... It seems that the military's minimum obligations are quite long though and I have yet to find one that would fit well with my agenda.")

It is not that I don't want to serve my country, it is just that I have had very little previous experience with the military and am therefore hesitant about signing up for an 8 year contract. With that being said, I do care about serving my country but, to be honest, it has not been a primary focus throughout my life. I also do care about what fellowship I get into and feel that I can still serve the county as a civilian doctor, just in a very different way.

Anyways, I know this is a personal decision so I will spend some time considering it. Thank you again for your help.

P.S. I have previously volunteered for the VA and really enjoyed it. If I don't join the military I will definitely try to include the VA in my civilian practice.

 

[gingerhulking]

Air Force signing bonus is currently on hold so thats something to keep in mind....a bunch of us received an email on Friday saying they are aware of problems w/ issuing all signing bonuses (since April).

 

[BunnyMan17]

Can you please explain what an MTF is?

MTF=Military Treatment Facility. Essentially means a military hospital or clinic.

 

[cpaw2113]

I am currently applying to medical schools and thinking about the prospect of HPSP. I am looking into each branch and I have a few questions after reading what is already here:

1. What are the pros and cons to each branch? Why should someone pick one over the other two? (Army, Navy, Air Force) I am currently leaning Air Force but I don't feel I know them well enough.

2. I don't understand those who say it doesn't make sense to do HPSP for financial reasons? I see it as financial freedom during medical school and a hugggee head start to making money (especially if you do a DOD residency and get paid much more at that time too) and no debt. I don't see how 4 years more with a public salary (obviously greater than military salary) could counteract for all these benefits.

Thank you!

 

[USAFDocAZ24]

I am currently applying to medical schools and thinking about the prospect of HPSP. I am looking into each branch and I have a few questions after reading what is already here:

1. What are the pros and cons to each branch? Why should someone pick one over the other two? (Army, Navy, Air Force) I am currently leaning Air Force but I don't feel I know them well enough.

2. I don't understand those who say it doesn't make sense to do HPSP for financial reasons? I see it as financial freedom during medical school and a hugggee head start to making money (especially if you do a DOD residency and get paid much more at that time too) and no debt. I don't see how 4 years more with a public salary (obviously greater than military salary) could counteract for all these benefits.

Thank you!

1. As far as branch choice, I think you need to do your research. Think of each branch as having a personality and if that doesn’t align with yours, probably not the branch for you. I can only speak to the Air Force as that’s the branch I chose.

2. If you sat down and crunched the numbers for HPSP vs. loan funding for school, you’ll come out on top just taking out loans. Physicians earn a good living and ability to pay off loans is not an issue with most practitioners. You’ll definitely have financial freedom either way. This is why joining HPSP simply just for money is a bad idea. Imagine not having that passion or drive for, or worse yet...hate, military service. You’ll be making less than your civilian counterparts (dependent on specialty) and you will be sent to where the military needs your services, all for the 4 years AFTER residency, not including if you do an active residency. If your only motivation is money, you could be in for a rough possible 10 years in the military (6 year active residency + 4 year pay back)

 

[Vladimir7]

1. As far as branch choice, I think you need to do your research. Think of each branch as having a personality and if that doesn’t align with yours, probably not the branch for you. I can only speak to the Air Force as that’s the branch I chose.

2. If you sat down and crunched the numbers for HPSP vs. loan funding for school, you’ll come out on top just taking out loans. Physicians earn a good living and ability to pay off loans is not an issue with most practitioners. You’ll definitely have financial freedom either way. This is why joining HPSP simply just for money is a bad idea. Imagine not having that passion or drive for, or worse yet...hate, military service. You’ll be making less than your civilian counterparts (dependent on specialty) and you will be sent to where the military needs your services, all for the 4 years AFTER residency, not including if you do an active residency. If your only motivation is money, you could be in for a rough possible 10 years in the military (6 year active residency + 4 year pay back)

You know, when it comes to pay there are more factors than med school debt vs. civilian physician pay. You gotta look at several things too (which you may already be doing idk):

- Discounts / free memberships with literally thousands of different companies (may seem insignificant, but it adds up)
- In the military a large chunk of your paycheck is not taxed
- You are paid 2x more during residency/fellowship (that extra money in residency and medical school can actually be very significant if you invest or save smartly)
- Your interest rates are lower across the board (SCRA)
- Your malpractice is lower
- Healthcare is free for you and your family
- Your life insurance premiums are lower as well (hell, through military banking options almost if not all of your insurance options are cheaper)
- Then there's military retirement which is a whole 'nother discussion

With all that said, I happen to believe that physicians come out on top financially through the military personally, but thats arguable and depends on personal decisions like getting a doctor house/car vs. living extremely frugally with a high paying specialty for 5 years (if you're primary care, good luck paying off 400k in debt (principal + interest thats been accruing since day 1))

Should someone join the military only for the money? hell no, agree with you entirely on that point.