HPSP Residency and Active Duty Questions

[Limvostov]

I am considering joining the Air Force this month. It's something that I have wanted to do for a long time, but I have three major questions about this choice.

1) How long are the unaccompanied tours during the 4 years of active duty? I really just want to know how long my wife and future children will be without their dad.

2) How much of a chance is there that I will be stationed over seas? This is not as much of a concern as my wife and I would like to go back to Germany or Spain again and I can imagine that another country would be fun too. I'm just a little curious about it because I have heard mixed stories.

3) The biggest question. Will the military force me into a specialty that I don't want to do? For example, say I want to be an orthopedic surgeon and I have the scores and experience to get into the discipline, but the military residency match has too few positions to give me one as well. I would then apply to get deferred to a civilian residency (from what I understand), but if the military didn't grant me deferment could it stick me into an internship year or a specialty that I don't want to do? Does that happen? I don't want my desire to serve and see some of the world to get in the way of my future career goals that will effect me the rest of my life.


Thanks for the help.

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[afdoc77]

To answer your questions:
As an AF doc, most deployments are 4 months, but there are some that are going to 6 months.
Can you be stationed overseas: absolutely. Whether you can do it or not, depends on your specialty and the needs of the AF. Remember, when you sign on that dotted line and raise your right hand you lose some freedom of choice in your life. The AF can and will do what they need you to do, only taking into consideration what you want you to do if it fits into their plans. For instance, if you're an orthopod, but all the spots are filled at Ramstein for orthopods, you're not going to Germany. There are ways around it by doing hardship tours, etc., so if you really want it, it can be done.

The residency question... Coming out of medschool there are a prescribed number positions for every specialty that the military allows, based on what they need (does this sound familiar...) So if you want to do ortho, and the AF needs 15 (4 active duty spots and 11 civilian spots, lets say), but 60 med students around the country are wanting to do ortho who are HPSP students, well then you're competing against those folks. Lets say you don't get one of the 15 spots, then you'll do an internship and can reapply for ortho (or another specialty) during your internship. If you don't get it, then you're going to go into the AF as a general medical officer and start paying back your time. You can again reapply for residency during this time as well. So in order to answer your question in one short sentence: The AF won't force you to go into a specialty you don't want, with one caveat. A classmate of mine in med school was a top 5 guy in our class. He was also HPSP for the AF. Blew off all the requirements of HPSP--doing the two rotations during 4th year at mililtary hospitals, etc. (I forget the others, its been a few years) Anyway, he applied to the civilian residency (without going through the military match) and was accepted in to the USC ENT program. However, the military would not let him go, and instead put him in a Int Med residency in Biloxi. No joke. So, if you obey their rules, you will not be put in a residency you don't want, but it just may be a circuitous path to get there.

 

[Limvostov]

So it looks like if you follow the rules and show enough desire they will not force you into a specialty that you really don’t want to do.

As far as the internship years... do those need to be repaid to the military as well?

Four more questions...

1) Does the military do anything tricky... like making a typical 5yr residency 6 years in the military to force you into essentially two extra years of service? Right now there is no penalty for a 5yr or shorter residency, but if I had to do 6yrs then I would owe another year of active service for every one over 5 on the residency.

2) Can you apply to match in several specialties (say... Ortho, ENT, and Uro) in order to have a better chance at doing something that you would enjoy and find challenging?

3) How likely is it that the military will not grant someone deferment to a civilian residency if they are accepted to one but not a military one because of lack of spots?

4) How likely is it that my family would have to move to some crapistan country for the 4 years? I have looked at the list of AF base hospitals and most of them are stateside. I don't mind doing tours for 4-6 months, but I would never want my wife and children to have to live in a dangerous place with me.


There is so much to think about with this big of a decission.

 

[The White Coat Investor]

I am considering joining the Air Force this month. It's something that I have wanted to do for a long time, but I have three major questions about this choice.

1) How long are the unaccompanied tours during the 4 years of active duty? I really just want to know how long my wife and future children will be without their dad.

2) How much of a chance is there that I will be stationed over seas? This is not as much of a concern as my wife and I would like to go back to Germany or Spain again and I can imagine that another country would be fun too. I'm just a little curious about it because I have heard mixed stories.

3) The biggest question. Will the military force me into a specialty that I don't want to do? For example, say I want to be an orthopedic surgeon and I have the scores and experience to get into the discipline, but the military residency match has too few positions to give me one as well. I would then apply to get deferred to a civilian residency (from what I understand), but if the military didn't grant me deferment could it stick me into an internship year or a specialty that I don't want to do? Does that happen? I don't want my desire to serve and see some of the world to get in the way of my future career goals that will effect me the rest of my life.


Thanks for the help.

1) Currently 6 months of every 24. Was three when I signed the paperwork 10 years ago. Probably will change before you do one.

2) Very tough to go to Europe on a first assignment. Usually they reserve those assignments to try to get people to do a second tour instead of getting out.

3) No, they won't force you to do a residency, but they may force you to do an internship you don't want to do and be a GMO (search the forum if you don't understand what this is) rather than deferring you to the civilian match. This happens often to lots of good medical students. Don't assume it can't happen to you. This is the single biggest risk with the HPSP scholarship and the reason I recommend against it to most people, even those who know they want to be military docs.

Good luck.

 

[The White Coat Investor]

So it looks like if you follow the rules and show enough desire they will not force you into a specialty that you really don't want to do.

As far as the internship years... do those need to be repaid to the military as well?

Four more questions...

1) Does the military do anything tricky... like making a typical 5yr residency 6 years in the military to force you into essentially two extra years of service? Right now there is no penalty for a 5yr or shorter residency, but if I had to do 6yrs then I would owe another year of active service for every one over 5 on the residency.

2) Can you apply to match in several specialties (say... Ortho, ENT, and Uro) in order to have a better chance at doing something that you would enjoy and find challenging?

3) How likely is it that the military will not grant someone deferment to a civilian residency if they are accepted to one but not a military one because of lack of spots? These numbers are specialty, service, and year specific. The year I applied 25% of applicants matched into military residencies, 25% were deferred, and 50% were put into internships/GMO tours. 2 year after that there were zero deferrments and the same number of military slots. It just depends.

4) How likely is it that my family would have to move to some crapistan country for the 4 years? I have looked at the list of AF base hospitals and most of them are stateside. I don't mind doing tours for 4-6 months, but I would never want my wife and children to have to live in a dangerous place with me.


There is so much to think about with this big of a decission.

1)Yes. You pay back commitment acquired for residency concurrently with commitment acquired from med school. If you did a 3 year HPSP scholarship, then did an internship (1 year), then did the rest of a general surgery residency (straight through 4 more years) you then owe 4 years. If you went off and did a GMO tour for 3 years after internship, you would have the option of getting out or going to a military residency. If you chose the military residency, you would owe 4 more years following residency. Tricky huh.

2) Yes. And the military will stick you in the one they need more of and have fewer applicants for (for instance if you apply to EM and FM, you will definitely be put in a family medicine slot). This is an extremely bad idea to put more than one specialty on your form.

3) Very likely. They won't actually let you enter the regular match in February if the military match in December selects you for something other than "deferment."

4) Pretty low. I tried my hardest to get to crapistan and they wouldn't let me leave the US on a first tour. But it is year, specialty, and service specific. But for the most part, people who go overseas volunteer for it. You WILL deploy to crapistan (and probably several other stans) while you're in though, but your family will stay at your home base.

If this seems like a big decision to you, you're probably not going to be happy in military medicine. Those who are happy find this decision was quite easy because they are more interested in being in the military than being a doctor. It's hard to say from just a few postings, but you don't seem like you're one of those. It sounds to me like you're trying to get a chance to give something back to your country, get med school paid for, and not get screwed over too badly. Those are the people who are unhappy in military medicine.

Good luck.

 

[Limvostov]

It sounds to me like you're trying to get a chance to give something back to your country, get med school paid for, and not get screwed over too badly. Those are the people who are unhappy in military medicine.

Good luck.

Those were my exact initial thoughts on joining the military... I think I need to really rethink this whole idea and make sure that it is something I will not regret before I sign the dotted line.

Thank you so much for helping me out and making this whole thing more clear.