HPSP then GMO and Out

[aaronrodgers]

Firstly, I am a current medical school applicant for USUHS and also HPSP. Could someone confirm if I understand this correctly - I intend on applying for a 3 year HPSP in either AF or Navy and thus incur a 3 year AD commitment. I would like to do the 3 year GMO tour as a flight surgeon and join a civilian residency. However...

1. There is an internship after medical school so does that mean I am active duty for a total of 4 years after graduation (1 year internship + 3 years GMO)?

2. If I am doing a 3 year commitment and a GMO tour is usually 2 years, what happens in that 3rd and final year?

3. What kind of medical internship after medical school are we talking about? Is it learning primary care...or are there different kinds? If there is only one medical internship, does that mean a student interested in surgery undergoes the same year as a student interested in family med?

4. Lastly, when do future GMO take the flight surgeon course? Is it during the 1 year internship? AF is like 6 weeks while I know Navy is 6 months...

Thanks for considering all my questions!

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[Cooperd0g]

1. Yes, if you did a 3 year HPSP you would do an internship plus your 3 year payback for a total of 4 years.

2. A "regular" GMO tour is 2 years. You could most likely extend in that job until you got out. In the Navy a typical flight surgery tour is going to take you through 3 years because of the training and tour length.

3. Internships vary based upon the specialty you go for: pediatrics, internal medicine, transitional, general surgery, orthopedic surgery, otolaryngology, psychiatry, family medicine, etc.

4. After internship.

 

[WernickeDO]

Firstly, I am a current medical school applicant for USUHS and also HPSP. Could someone confirm if I understand this correctly - I intend on applying for a 3 year HPSP in either AF or Navy and thus incur a 3 year AD commitment. I would like to do the 3 year GMO tour as a flight surgeon and join a civilian residency. However...

1. There is an internship after medical school so does that mean I am active duty for a total of 4 years after graduation (1 year internship + 3 years GMO)?

2. If I am doing a 3 year commitment and a GMO tour is usually 2 years, what happens in that 3rd and final year?

3. What kind of medical internship after medical school are we talking about? Is it learning primary care...or are there different kinds? If there is only one medical internship, does that mean a student interested in surgery undergoes the same year as a student interested in family med?

4. Lastly, when do future GMO take the flight surgeon course? Is it during the 1 year internship? AF is like 6 weeks while I know Navy is 6 months...

Thanks for considering all my questions!

1: Yes. Intern year does not pay back any commitment time but you do not accrue more either.
2: If you decide that you like life in the military and want to stay in, then you can apply to residency or just continue being a flight doc if you want to get out.
3: Usually people who want to go operational just do the transitional year (TY) in which you will rotate thru peds, surgery, EM, IM, electives, etc. If you go Navy then you can do your internship in nearly anything and find yourself in a GMO slot following completion.
4: It will be after you complete internship.

 

[aaronrodgers]

1: Yes. Intern year does not pay back any commitment time but you do not accrue more either.
2: If you decide that you like life in the military and want to stay in, then you can apply to residency or just continue being a flight doc if you want to get out.
3: Usually people who want to go operational just do the transitional year (TY) in which you will rotate thru peds, surgery, EM, IM, electives, etc. If you go Navy then you can do your internship in nearly anything and find yourself in a GMO slot following completion.
4: It will be after you complete internship.

1. Yes, if you did a 3 year HPSP you would do an internship plus your 3 year payback for a total of 4 years.

2. A "regular" GMO tour is 2 years. You could most likely extend in that job until you got out. In the Navy a typical flight surgery tour is going to take you through 3 years because of the training and tour length.

3. Internships vary based upon the specialty you go for: pediatrics, internal medicine, transitional, general surgery, orthopedic surgery, otolaryngology, psychiatry, family medicine, etc.

4. After internship.

Thanks for the clarification from you both! One follow-up, why do people choose TY if they already have the choice to pursue, say, an emergency med internship and be more competitive for that field? By fourth year, one must already have an inkling of what field they prefer as oppose to needing to do more rotations Also, How does TY make you more operational?

 

[Gilakend]

Not trying to highjack the thread but was wondering this, say you wanted to do Navy GMO, does the 6 months for flight surgery count towards payback? Or does it not start till you have a duty station?


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[WernickeDO]

Thanks for the clarification from you both! One follow-up, why do people choose TY if they already have the choice to pursue, say, an emergency med internship and be more competitive for that field? By fourth year, one must already have an inkling of what field they prefer as oppose to needing to do more rotations Also, How does TY make you more operational?

Why indeed? Most people who end up as TYs did so because they didn't match to a specialty. Some truly don't know what they want to be when they grow up but they are the minority.

TY doesn't make you more operational, it just puts you to the front of the line to get an operational job. Although, I would say that someone who did a TY is more prepared for the primary care involved in a GMO tour then, say, someone who spent a year with gen surg or ENT.

 

[WernickeDO]

Not trying to highjack the thread but was wondering this, say you wanted to do Navy GMO, does the 6 months for flight surgery count towards payback? Or does it not start till you have a duty station?


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Yes, payback of active duty service obligation (ADSO) begins when you graduate internship.

 

[aaronrodgers]

Why indeed? Most people who end up as TYs did so because they didn't match to a specialty. Some truly don't know what they want to be when they grow up but they are the minority.

TY doesn't make you more operational, it just puts you to the front of the line to get an operational job. Although, I would say that someone who did a TY is more prepared for the primary care involved in a GMO tour then, say, someone who spent a year with gen surg or ENT.

Thank you for the response, makes much more sense now.

 

[Cooperd0g]

Remember that each service is different. The Navy does not let you apply to PGY-2 programs directly from medical school. Many specialties that people DO want don't have a categorical internship such as dermatology, ophthalmology, radiology, PM&R, anesthesia, occupational med, prev med, etc. Many people who want to do those specialties choose a TY year on purpose. The majority of my old TY class chose TY for that reason.

 

[aaronrodgers]

Remember that each service is different. The Navy does not let you apply to PGY-2 programs directly from medical school. Many specialties that people DO want don't have a categorical internship such as dermatology, ophthalmology, radiology, PM&R, anesthesia, occupational med, prev med, etc. Many people who want to do those specialties choose a TY year on purpose. The majority of my old TY class chose TY for that reason.

Likewise, many programs would prefer you to repeat your internship year correct? applying into PGY2 seems unlikely for most GMO -> civilian residency folks. Does Air Force let you apply into PGY2?

 

[Cooperd0g]

I can't speak to that. Some civilian programs are PGY2+ and some include their own categorical. So it depends.

 

[MirrorTodd]

Don't take the bonus if you do sign up for hpsp because it tacks on an extra year of payback time. Instead of 3, you'll owe 4 years back.

 

[pgg]

Why indeed? Most people who end up as TYs did so because they didn't match to a specialty. Some truly don't know what they want to be when they grow up but they are the minority.

TY is actually relatively competitive. A lot of future dermatologists, radiologists, anesthesiologists, and other specialists want those spots because being a medicine or surgery intern sucks a whole lot worse, and the medicine/surgery intern experience isn't required or better prep for those residencies.

Particularly in the Navy where GMO tours are essentially mandatory for some of those specialties, TY is good prep for a GMO tour because of the elective time and the outpatient tilt to the year.


Edit - About half my TY had no weekends or call, and I had no "continuity clinic" pain either. It's good work if you can get it ...

 

[Detective SnowBucket]

I know it isn't common (especially with Navy HPSP) but how hard is it to only start ADSO after residency? Also, which branch would be most likely to allow it.

 

[psychbender]

I know it isn't common (especially with Navy HPSP) but how hard is it to only start ADSO after residency? Also, which branch would be most likely to allow it.

Do you mean how common is it to train straight through (med school-->internship-->residency), then start your ADSO? That's basically the default in the Army, and it's not totally uncommon in the other two branches, for some specialties.

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[backrow]

I know it isn't common (especially with Navy HPSP) but how hard is it to only start ADSO after residency? Also, which branch would be most likely to allow it.

I don’t understand the question. Are you asking how hard it is to get a deferred residency? (I.e. you are HPSP, you graduate medical school, you go to residency on your own, and then start your payback for HPSP after that?)

If that is your question then for Navy it depends entirely on the year and what you want to do. I believe there are some anesthesia spots this year. Many others will have no spots. All depends on the BUMEDNOTE 1524 publishes that year.


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[Detective SnowBucket]

Thanks @backrow & @psychbender , I guess I meant where you're going with it psychbender, anywhere I could find what specialties (or even better, what specialties within each branch) this is more common for?

Also, backrow, are the BUMEDNOTE reports pblished? I'd like to look through those for the past few years to get a feel of what/who does this.

Also, do either of you have any input on how hard it is to do a civilian residency after HPSP (would I be considered an self-riteous self-entitled lil b****, if i asked to defer ADSO and civilian residency? )

 

[psychbender]

Thanks @backrow & @psychbender , I guess I meant where you're going with it psychbender, anywhere I could find what specialties (or even better, what specialties within each branch) this is more common for?

Also, backrow, are the BUMEDNOTE reports pblished? I'd like to look through those for the past few years to get a feel of what/who does this.

Also, do either of you have any input on how hard it is to do a civilian residency after HPSP (would I be considered an self-riteous self-entitled lil b****, if i asked to defer ADSO and civilian residency? )

You can only do a civilian residency if the service projects that it needs more of that specialty than it can train internally. This very rarely happens in the Army, but it's rather common in the Air Force (since they have few GME programs). The Air Force, though, may just tell you good luck with that, have fun being a flight surgeon for two to four years. It also sometimes happens in the Navy. I know several Navy anesthesiologists who trained at civilian programs.

If your service doesn't think it needs to train anyone externally, then it doesn't matter how much you want to train civilian, it won't happen. You'll get the choice to train internally, or do your time as a flight/battalion surgeon, then depart the military and train civilian.

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