HPSP, research careers, and specialization

[maybeimmonke?]

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Hi, I'm going to try to keep this from being super long-winded but dunno how well I'll do. I really appreciate any feedback after reading since this is a big crossroads for me.
I am currently waist-deep in the HPSP application process through the Air Force.

To get it out of the way, my primary reason for choosing HPSP is essentially patriotism; I see choppy waters ahead and want to feel like I'm helping my country navigate them while practicing medicine (I know it sounds naive and cheesy). Not having debt now is nice, but I understand that is not a financially good decision for most people.

Despite this, I have some concerns. I have always been very interested in research and will be attending a research-heavy med school. I'm already concerned with losing my first summer research opportunities to OTS, but would love some perspectives on research opportunities as a military physician.
Question 1:
My "ideal" career path would see me specializing in something (hem/onc, immunology, who knows I haven't started school yet) and transitioning to government research positions (NIH, CDC, etc) later in my career after my service. I know this is aspirational, but is it stupid? Does working as a military doctor help you work towards positions like that inside the gov but not DoD?

Question 2.(1-4): •most important for me•
Even if I decide to aim elsewhere than the above, I would still like to do IM -> IM subspecialty. What does military medicine after an IM residency look like? Are you a GMO/FS? Will this hurt my application for civilian fellowships after service, assuming I'm not able to do my fellowship while still in service? The reason I ask this question is I keep hearing about skill atrophy or difficulty adjusting to civilian med after treating relatively healthy soldiers for so long.

Question 3:
Does anyone have any detail on what specialty research is available while in milmed, and what that looks like?

Again, thank you for taking the time to read all this and help me out. I'm really just trying to get as much info as I can since I know a lot of the info I've been getting are from people trying to get me to join.

 

[afteranesthesia]

Yes, it is stupid. How about working for the VA or something or doing charity work every year? Doing HPSP - you lose complete control of your career, and you seem to have a lot of ideas about what YOU want, but what you don't understand is the military doesn't care what you want. They only care what THEY want. I truly don't understand why no one knows this, and we see the same posts over and over and over again here.

 

[armytrainingsir]

The goal of HPSP to produce clinical military physicians.

Do some people get to do research during and after? Absolutely. One of my attendings went on to do mostly academic research, and I met a couple of ex-navy guys that were NIH dudes.

But don’t confuse the fact that the purpose of the HPSP program is to put docs in clinical positions with troops and their immediate family

So, if your heart is set on a Big Mac, go to McDonald’s, not Burger King. if you just want a burger, either is fine.

 

[maybeimmonke?]

Yes, it is stupid. How about working for the VA or something or doing charity work every year? Doing HPSP - you lose complete control of your career, and you seem to have a lot of ideas about what YOU want, but what you don't understand is the military doesn't care what you want. They only care what THEY want. I truly don't understand why no one knows this, and we see the same posts over and over and over again here.

Thanks for the reply. My post might have been a little confusing, but I have read about HPSP on here and other places. I know you do not have control over what you do while in service. That's why my second question(s) were the most important to me. I think I'm prepared to have my payback time be 4 "voided" years as long as I don't come out a worse doctor for it. My biggest concern is if I'll be able to come out of service with the qualifications to get into a good civilian fellowship without having stunted my chances at doing research later in my career. Sorry for the confusion.

 

[FromKermitsHome]

Thanks for the reply. My post might have been a little confusing, but I have read about HPSP on here and other places. I know you do not have control over what you do while in service. That's why my second question(s) were the most important to me. I think I'm prepared to have my payback time be 4 "voided" years as long as I don't come out a worse doctor for it. My biggest concern is if I'll be able to come out of service with the qualifications to get into a good civilian fellowship without having stunted my chances at doing research later in my career. Sorry for the confusion.

I'm kinda in your boat as well. I'm an M1 seriously considering a 3 yr Navy HPSP scholarship.

I'm young and single (I don't know about you), so I'm much more amenable to the "needs of the Navy" as long as I'm having a fun time doing it. I have my heart set on the "GMO and out" path, but I'm worried about the matching opportunities to civilian residencies after that. I'm seriously worried that civilian residencies won't want anyone who did 3 years on a boat with no research. I haven't talked with any physicians that did this path and matched successfully to their 1st choice civilian. That is someone I would need to talk to.

 

[FromKermitsHome]

The goal of HPSP to produce clinical military physicians.

They should put that as a disclaimer on the brochure, lol.

I do have a question, though:
Have ever you seen someone doing a "GMO and out" route, then successfully matching to their high-ranked choice civilian residency? I'm worried that three years as a GMO without any research may make me less competitive in the civilian world. For context, I want nothing to do with the Navy after I separate (other than quietly finish my reserve duties). So, a military residency is not ranked high on my future endeavors.

I still haven't accepted the 3 yr scholarship.

 

[Nontrad_FL_LGBT]

They should put that as a disclaimer on the brochure, lol.

I mean. It's a scholarship to recruit physicians for military billets, 95%+ of which are clinical or administrative. Seems kinda common sense tbh. They're not trying to recruit the next Einstein, that's what the civilian lab people are for.

 

[Apollyon]

It was 20 years ago, but, where I was a resident, a guy matched there in ortho, who would not otherwise have been looked at, who did GMO and out in the Navy. This place and ortho, you have 100% heard of as world-class.

 

[FromKermitsHome]

It was 20 years ago, but, where I was a resident, a guy matched there in ortho, who would not otherwise have been looked at, who did GMO and out in the Navy. This place and ortho, you have 100% heard of as world-class.

I've also heard anecdotes about GMO and out people matching into pretty decent residencies.

But others say it really depends on your prior competitiveness. At any rate I need to find someone who actually did that before I even think of signing up for HPSP.

But, thanks for sharing! It gives me a bit of hope that maybe I can live out this dream.

 

[FromKermitsHome]

I mean. It's a scholarship to recruit physicians for military billets, 95%+ of which are clinical or administrative. Seems kinda common sense tbh. They're not trying to recruit the next Einstein, that's what the civilian lab people are for.

I understand, I meant it as a tongue-in-cheek joke.

I'm pretty understanding that I belong to the Navy during my commitment, I just don't want the time I spend in the Navy to reduce my chances at a good civilian residency.

 

[comp1]

Goodness, come to the VA! There's not only the HPSP with the VA too, but the VA has research as a core mission (with LOTS of funding specific to its employees) and is going to be a heck of a lot less challenging regarding specialty choice (excepting peds). There are American and POW flags everywhere and it's all about service, etc. You even still get to take a paycut for your country! Albeit less of a cut than at the DoD. It'll scratch whatever patriotism itch you must have scratched and believe me, the waters will still be plenty choppy.

 

[maybeimmonke?]

The goal of HPSP to produce clinical military physicians.

Do some people get to do research during and after? Absolutely. One of my attendings went on to do mostly academic research, and I met a couple of ex-navy guys that were NIH dudes.

But don’t confuse the fact that the purpose of the HPSP program is to put docs in clinical positions with troops and their immediate family

So, if your heart is set on a Big Mac, go to McDonald’s, not Burger King. if you just want a burger, either is fine.

Do you know if there is a difference in the work you do as a military physician after completing IM residency? Or are you a GMO regardless of whether you're fresh out of med school or have completed IM residency?

 

[maybeimmonke?]

Goodness, come to the VA! There's not only the HPSP with the VA too, but the VA has research as a core mission (with LOTS of funding specific to its employees) and is going to be a heck of a lot less challenging regarding specialty choice (excepting peds). There are American and POW flags everywhere and it's all about service, etc. You even still get to take a paycut for your country! Albeit less of a cut than at the DoD. It'll scratch whatever patriotism itch you must have scratched and believe me, the waters will still be plenty choppy.

I'll definitely look into that, thanks. Had no idea HPSP was available through the VA.

 

[armytrainingsir]

Do you know if there is a difference in the work you do as a military physician after completing IM residency? Or are you a GMO regardless of whether you're fresh out of med school or have completed IM residency?

From my army experience:
You’ll go somewhere as an internal medicine doc. Maybe a big MEDCEN, maybe a small army hospital(MEDDAC), or even be sent to a troop medical clinic doing only outpatient work. Rare possibility that you would be a battalion surgeon doubling staff work.

At the end of the day where you go all depends on the “needs of the military“ at that moment.

But common things being common, you would be in a hospital somewhere as an internal medicine doc.

No idea where and how the AF differs from the army. I would guess is you could be tasked as a flight surgeon as the Air Force needs plenty of those, and internal medicine is primary care and flight medicine is primary care for a select healthy population.