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[deleted922750]

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[colbgw02]

I am a prior service enlistee, so I understand that 1 yr of HPSP scholarship in med school= 1 year commitment. Now my question is:

Scenario 1: After 4 years of med school, If I go through military residency (and most likely, I will), let's say for 4 years, is that another 4 years of commitment in addition to the years already incurred from med school? 4+4= 8 years of commitment?

You don't fulfill any obligation while in GME, so yes. A 4-year HPSP scholarship with a 4-year active duty residency would mean at least 8 years on active duty.

Scenario 2: If I only apply for 3 years scholarship, and I go through civilian residency; how much commitment will I have?

Should be 3 years, assuming that you are deferred and not full time out-service (FTOS).

Question 3: What are the chances of matching with civilian residency?

Depends. On a lot of things. The service, specialty, and luck (timing) have a lot to do with it.

 

[Perrotfish]

I am a prior service enlistee, so I understand that 1 yr of HPSP scholarship in med school= 1 year commitment. Now my question is:

Scenario 1: After 4 years of med school, If I go through military residency (and most likely, I will), let's say for 4 years, is that another 4 years of commitment in addition to the years already incurred from med school? 4+4= 8 years of commitment?

Scenario 2: If I only apply for 3 years scholarship, and I go through civilian residency; how much commitment will I have?

Question 3: What are the chances of matching with civilian residency?

At the end of a military residency you will owe either the number of years you owed at the start of the residency, or the length of the residency (not counting Intern year), whichever is more.

So if you have a 4 year scholarship and do a three year family residency you will owe 4 years at the end if residency.

If you do a 4 year scholarship, do an intern year and then a 3 year GMO, and then go finish up the last 2 years if residency then at the end if residency you will owe 2 years.

The chances of matching into a civilian residency vary wildly from year to year and specialty to specialty

 

[ArmyTiger]

can you cite this?

It's in every residency contract.

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[SirGecko]

can you cite this?

See perrotfish’s explanation for how it works. The 8 years total active duty in that senario includes the four years of residency.

 

[colbgw02]

It makes sense. You end up owing 8 years, but since residency is 4 years (and it counts as payback): 8-4=4. 4 more years of commitment after residency.


Now I have one more question:

Let's say I go for the HPSP scholarship for 4 years. What's the time line going to be?

4 years med school- 4 years residency- 4 years commitment.? Where does the GMO and Internship fall?

I can't tell if you think all residencies are 4 years or if you're just choosing that as an example, but assuming the latter...

Internship is always the first year after medical school (FYGME). You will do an internship, and it will neither add nor detract from your ADSO. Whether or not you do part of or an entire second internship depends on whether or not you become a GMO, which residency you return to afterward, and to a lesser extent - how long you were a GMO.

Becoming a GMO is not a foregone conclusion. If you were to receive a continuous contract or match into a PGY-2 position as an intern, then you would finish residency 4 years after medical school (again, just using a 4-year residency as an example), with 3-year GME and 4-year HPSP obligations. These are paid back concurrently, meaning you would spend 8 years on active duty.

If you were to become a GMO for two years after internship, then you would have paid back 2 years of your HPSP obligation during that time, leaving two years left. Let's say then you then enter an anesthesia residency (PGY-2 through 4). Upon residency graduation you would then have 2-year HPSP and 3-year GME obligations. These are served concurrently, meaning you would spend 10 years on active duty.

 

[colbgw02]

What is a GME? is this synonymous to residency? Or is this a commitment in addition to residency and HPSP?

GME = graduate medical education, so basically internships, residencies, and fellowships.

With the exception of internship (FYGME), doing any military GME incurs its own obligation . However, a GME obligation can be paid back concurrently with an HPSP obligation.

 

[colbgw02]

Where are you getting the 10 years from here? When I was doing the calculation... it was still 8 years.

It's actually 9. I originally gave an example that went through PGY-5, but then forget to edit it correctly. In any case, I'm talkng about a residency that involves PGY-2 through PGY-4. That incurs a 3-year GME commitment, so the years stack up like this:

1: Internship - owe four years from HPSP
2: GMO - owe 3 years from HPSP
3: GMO - owe 2 years from HPSP
4: PGY-2 - owe 2 years from HPSP, 1 from GME
5: PGY-3 - owe 2 years from HPSP, 2 from GME
6: PGY-4 - owe 2 years from HPSP, 3 from GME
7: Attending - owe 1 year from HPSP, 2 from GME
8: Attending - owe 1 from GME
9: Attending - separate

Where are you getting the 10 years from here? When I was doing the calculation... it was still 8 years.


So if I'm understanding this correctly (assuming a 3 year residency after 1st year internship), from the scenarios you have given me:

Scenario 1:

+4 yrs med school (HPSP) --> 1 yr PGY-1 (internship) --> 3 yrs residency = 4 more years of service obligation after residency.
8 years total in the military given that PGY-1 is already considered Active duty.

This is correct.

Scenario 2:

+4 yrs med school (HPSP) --> 1 yr PGY-1 (internship) --> -2 yrs GMO (pays off 2 yrs of HPSP) --> 3 yrs residency = 2 more years obligation after residency.
still 8 years total military service starting from PGY-1.

The rub lies in the bolded. If you re-enter training as an intern, then you would only incur a 2-year GME obligation and be able to separate two years after finishing residency. If you re-enter training at an "advanced" program, like anesthesia, for example, then you would incur a 3-year obligation. Nine years, as I tried to outline above.

 

[ladylove5678]

I am a prior service enlistee, so I understand that 1 yr of HPSP scholarship in med school= 1 year commitment. Now my question is:

Scenario 1: After 4 years of med school, If I go through military residency (and most likely, I will), let's say for 4 years, is that another 4 years of commitment in addition to the years already incurred from med school? 4+4= 8 years of commitment?

Scenario 2: If I only apply for 3 years scholarship, and I go through civilian residency; how much commitment will I have?

Question 3: What are the chances of matching with civilian residency?

Hi! I do not know how much this helps, but I was told by an Air Force advisor that "Time spent in a military residency or fellowship program does not count towards service obligation." I interpret that as meaning only the 4 years (or however many years) that the military has paid for medical school only counts towards the service obligation. however, i remember reading on another thread that this is only true if your residency is less than or equal to 4 years.

 

[ArmyTiger]

Your residency adds a commitment equal to the length of time in residency minus 1 (intern year is free) that's served concurrently with any other ADSO. For any residency less than 5 years total (to include residency), that means no extra commitment. For any over 5 years, you're adding time past your HPSP commitment.

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[colbgw02]

Thanks for the detailed response!



However, i just spoke to a recruiter and he told me that if I will be applying for a 4 year scholarship, i will NOT incur commitment from GME. I will only owe the original 4 years from the HPSP scholarship.

Now... idk which one is true. I mean no disrespect, but are these answers based on your own experiences? Are you an HPSP student?

Recruiters not knowing up from down is a common issue regarding military medicine. Best case scenario is that he/she is misinformed; worst case scenario is that he/she is lying to you. Caveat emptor.

I mean, I'm just a random guy on the internet, but to answer your questions: yes and no. Like a lot of people on this forum, I'm a former medical corps officer who separated a few years ago.

 

[colbgw02]

So let's say I'm going for anesthesiology: PGY1 Internship + 3 years of residency. Is it possible to only use the HPSP scholarship for the last 3 years; and only incur a 3-year ADSO after residency, since PGY-1 doesn't count?

Yes. Assuming a GMO tour doesn't get in the middle, then you would finish residency in this hypothetical with both a 3-year HPSP and 3-year GME obligation, to be served concurrently.

 

[ArmyTiger]

Yes. That said, of 200ish people in my med school, I'd say maybe 10% went into the specialty they entered med school expecting to go into. I wouldn't plan on owing only 3 years.

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[colbgw02]

It doesn't. He's pointing that there is a decent chance that you'll choose a specialty whose residency is 5 or 6 years (including internship), which would make your GME obligation longer than what you owe from a 3-year HPSP scholarship. Put another way, as a 3-year HPSP guy, you would never choose anesthesia when you really want to be a urologist just because the former gets you out of uniform faster.

 

[Clap MD]

Also depends on what conditions you're talking about completing residency under. Active Duty? Civilian sponsored? Civilian deferred? The first two will incur additional payback (served concurrently for AD, consecutively for civ spons), the last won't. So the recruiter wasn't lying, but he wasn't telling the whole truth. Most likely incompletely informed, which isn't uncommon.

 

[pgg]

The majority of physicians don't end up in the specialty they thought they would, when they were premeds planning out their lives.

There are a lot of reasons for this. Some get exposed to something as a med student that they hadn't considered or even known about, and fall in love with that specialty. Some enter with grand ambitions of derm/ENT/plastics/etc and simply aren't competitive enough for those specialties (no one enters med school thinking they'll finish in the bottom 1/4 of their class, but exactly 1 in 4 do). Many learn painful and surprising lessons as med students that the field they imagined as a premed is very different in reality ... a huge number of premed surgeon-wannabes get exposed to that life, recoil in horror, say F this, and do something else.

I solidly changed my mind at three times as a med student, and considered a good 5 or 6 other possibilities with variable degrees of seriousness along the way.

The moral of the story is that all of the detailed math you've been doing in this thread rests on the very thin foundation of an assumed future specialty. I'm not saying you shouldn't do the math and fully understand it - just that odds are very high that what you currently think you'll do won't be the specialty you end up in.

The necessity of GMO time is also very unpredictable, service dependent, and specialty dependent.

Don't take HPSP unless you're OK with the notion of a solid decade of military service after medical school. If you are - welcome. I'm not trying to dissuade you from HPSP. All of us on active duty want our future colleagues to join with fully informed and realistic expectations, because they will be happier and so will the people they work with (us).