Married students- HPSP, NHSC??

[bgeyer15]

Hi, my wife and I are entering school in the fall and are trying to determine how we want to pay for our schooling. As most of us already know, there are a few options. First off, we could take out loans... that is a LOT of debt for two married medical students, especially since we are going to an osteopathic school which is typically more expensive than allopathic schools. Yes, we could eventually pay off our debts with two physician incomes, but we are mainly becoming physicians to travel on overseas medical mission trips and would love to not have the debt hanging over our shoulders if possible. Secondly, there is the National Health Service Corps, which is a great program for people wanting to work in rural medicine. We definitely do, but the Health Professions Shortage Area has to now have a score of 17 or higher, which reduces the number of qualified areas and we're concerned that it would be difficult for both of us to receive the same location (or vicinity). Also, we would like to become oncologists (or at least have the option to), and it seems like we wouldn't be able to do that if we did NHSC (please correct me if I'm wrong). Finally, there is the military... Air Force, Navy, Army. It sounds great. Debt-free, monthly-stipends, potential to travel and see the world while being paid by the military. Awesome deal. However, like the NHSC, we're concerned that we would not be able to be stationed together (although I hear it is easier to do so with similar career-fields), and I don't like the possibility of being deployed at separate times. Could a HPSP receipent or someone that knows of the program fairly well tell me whether you can request to be deployed if you have already been so? You know, if my wife is deployed after I come back from deployment, could I just be shipped off with her? We'd rather live anywhere in the world together, than living apart. I understand this is a long post, but I have been studying these topics for awhile and I seem to be coming to a brick wall. Any advice, opinions, information would be GREATLY appreciated!!! Thanks so much for your time!

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[st2205]

If you did internal medicine with the NHSC you could theoretically still do a fellowship after fulfilling your payback. If you comb these forums, you won't find a single positive comment about the NHSC. Obviously you'll get more dissatisfied individuals posting online, but the fact that over the three or so years that I've looked at the program, to not have anyone even mildly satisfied raises eyebrows. I'd give stronger consideration to loans. You may graduate without debt on either path but I assure you that you will be paying for your medical education any way you slice it. I think not taking a scholarship gives you more flexibility for doing medical missions during the payback period.

 

[smq123]

- If you do the NHSC, you would not be able to be oncologists, at least not for many years. You can do a fellowship after your service payback, but not everyone wants to wait.

I would disagree that absolutely no one is satisfied with the NHSC ... I have met people who loved it. But it does not sound like a good fit for you.

- For HPSP, I think it would be difficult to get coordinating deployments.

All in all, I agree that loans and living frugally are your best bet.

 

[bgeyer15]

Thank you both for your input. It seems that loans are our best bet right now. It seems like the other two programs would be amazing, but it wouldn't be worth it if we could be with eachother throughout our paybacks. Thanks again!

 

[Brachyury]

Do a search and read the military med forums.

Just because you can do your residency in the military does not mean that the military will allow you to do a fellowship. If the military needs you as an internist, they're not going to approve you to do a heme/onc fellowship.

Unlike the HPSP, the NHSC scholarships are incredibly competitive. Also, if you were interested in ID or rheum, you probably wouldn't have a problem landing a fellowship after 4 years of private practice. However, heme/onc, like cardiology and GI, are very competitive fellowships, and your chances of landing a fellowship in one of these after the NHSC probably are not that good

 

[Dictionaria]

When they spoke to us about being married as an ROTC cadet, they did talk about deployment. These days getting deployed as a couple is easier than ever--some of our instructors had lived in little trailers together in Iraq. Cozy. 😎

I think there was something about this being a limited option... one of them said she had left active duty for the National Guard because she would have had to be deployed without her husband for the first time if she had stayed in. Considering how long they were in, that's pretty impressive that they had been deployed only together for the time they had been married. I think they had similar or complementing jobs, which does make it easier.

Additionally, we were told at one point that you could sign contracts to prevent them from stationing you more than a set distance apart when not deployed, but things may have changed since then.

Recruiters can be kind of shady to talk to about this because they can be overly optimistic and make promises before they know if they can keep them. Best bet is to ask a married military couple if you can find one.

 

[picaresque]

You should keep the income based repayment program in mind as well. Although this is still a very new program, it does have some promise. I'm sure it's explained very well elsewhere, but as I understand it, you make payments on your loans not to exceed 10% of your monthly income. If you make these payments for 10 years while working in a public hospital any remaining debt is forgiven. The nice thing (to my understanding) is that you can start making these payments in residency (when your monthly salary is pretty low) and these years will count toward your 10 years as long as you're at a public hospital. By the time you finish residency/fellowship/whatever, you may be nearly debt free, or only a few short years from it and then you'll be free to work abroad without any debt skeletons in your financial closet.

 

[montessori2md]

Agree w/ above post re: 10 years of service.

1) As I understand it, oncologists make some serious dough in private practice.
2) You are going to have a hard enough time matching to the same geographic area for residency, then fellowship, and then finding jobs in the same area. Don't add to that by jumping feet first into something else.
3) Scholarships should never be chosen for the money. They should be chosen because the service obligation is something you would want to do, even without the scholarship.
4) Totally disagree w/ above re: NHSC. See point 3. I am a scholar/student (I think smq is too), and while NHSC has its Russian bureaucracy and limitations, I have met scholars in multiple specialties who are satisfied with their careers. The retention rate for scholars exceeds 80% after they complete their obligation -which tells you they aren't all running away screaming at the end of their commitment. But I also agree it doesn't sound like a good fit for 2 budding oncologists.
5) I know it is difficult, but try not to let the loans hanging over your heads bring you down. Two of you going through training together is stressful enough.

 

[Brachyury]

You should keep the income based repayment program in mind as well. Although this is still a very new program, it does have some promise. I'm sure it's explained very well elsewhere, but as I understand it, you make payments on your loans not to exceed 10% of your monthly income. If you make these payments for 10 years while working in a public hospital any remaining debt is forgiven. The nice thing (to my understanding) is that you can start making these payments in residency (when your monthly salary is pretty low) and these years will count toward your 10 years as long as you're at a public hospital. By the time you finish residency/fellowship/whatever, you may be nearly debt free, or only a few short years from it and then you'll be free to work abroad without any debt skeletons in your financial closet.

Loans originating before June 1, 2014 are at 15% of income; loans originating on or after June 1, 2014 will be at 10%.

The 15% is on your taxable salary minus a poverty level adjustemnt: for example, if the poverty level for a single person is 12k, and you make 50k and contribute 10k to a 401k, your taxable income is 40k, minus the poverty deduction of 12k gives you 28k, thus 28k*.15 = $4,200 a year

 

[Tekar]

Hi, my wife and I are entering school in the fall and are trying to determine how we want to pay for our schooling. As most of us already know, there are a few options. First off, we could take out loans... that is a LOT of debt for two married medical students, especially since we are going to an osteopathic school which is typically more expensive than allopathic schools. Yes, we could eventually pay off our debts with two physician incomes, but we are mainly becoming physicians to travel on overseas medical mission trips and would love to not have the debt hanging over our shoulders if possible. Secondly, there is the National Health Service Corps, which is a great program for people wanting to work in rural medicine. We definitely do, but the Health Professions Shortage Area has to now have a score of 17 or higher, which reduces the number of qualified areas and we're concerned that it would be difficult for both of us to receive the same location (or vicinity). Also, we would like to become oncologists (or at least have the option to), and it seems like we wouldn't be able to do that if we did NHSC (please correct me if I'm wrong). Finally, there is the military... Air Force, Navy, Army. It sounds great. Debt-free, monthly-stipends, potential to travel and see the world while being paid by the military. Awesome deal. However, like the NHSC, we're concerned that we would not be able to be stationed together (although I hear it is easier to do so with similar career-fields), and I don't like the possibility of being deployed at separate times. Could a HPSP receipent or someone that knows of the program fairly well tell me whether you can request to be deployed if you have already been so? You know, if my wife is deployed after I come back from deployment, could I just be shipped off with her? We'd rather live anywhere in the world together, than living apart. I understand this is a long post, but I have been studying these topics for awhile and I seem to be coming to a brick wall. Any advice, opinions, information would be GREATLY appreciated!!! Thanks so much for your time!

All I can say is are you guys out of your friggin minds...you're going to be done with medical school with about 720k in loans or more and 400ish in annual earnings. You can pay that down in 4 years and still live the high life if you guys don't run your tails off. Stay away from any and all free options for school, pick up the debt and enjoy your traveling on a two doc salary.

Seriously!!!