Navy Medical Special Pays

[TLAD123]

Hello - another question about the special pays (sorry if it's been asked before - I did a quick forum search and unless I missed the blatantly obvious, I didn't see anything conclusive to answer what I'm asking).

I reviewed the Navy BUMED's documents on physician special pays and am wondering:

First, could you please define "Years of Creditable Service"? Is this total time in military, including previous service, minus USUHS/HPSP? Or is this only from internship and on?

Pay:
Would a hypothetical physician, having completed an internship, 3 year GMO tour, 3 year residency, and 3 year payback for residency, also passing his/her boards (10 year total), be eligible for all of the following: ASP, VSP, ISP, MSP, and BCP? I can't find anything in the language of the document that excludes one or the other given this scenario...

So the hypothetical single, emergency medical physician (chose this specialty for example), living in Jacksonville, FL, at that time being a rank of O4 with 10 years of service, would potentially be making:


$96,386.88 + ASP $15,000 + VSP $11,000 + ISP* $30,000 + MSP* $40,000 + BCP $3,500 = $195,886.88

* ISP and MSP based on 4 year agreement -- all numbers based off of Years of Creditable Service being 10.


Is that correct? I recognize as stated in the document that MSP and ISP are not guaranteed, and note that ASP and VSP are entitlements. Are these usually always granted to those that request, or is it common now that MSP and ISP are not given? If married and live in an area with higher cost of living, pay could be more... seems pretty close to the numbers I've been hearing is a civilian ER physician's pay. Granted, a military physician is nearing the middle/end of a military career once they can finally make this much, with a 2-3 year GMO tour and residency payback period that incur high opportunity cost.

Thanks for the time!

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[AFM]

Sounds about right. There would be mass anarchy if those were not given to physicians every year.

 

[colbgw02]

Based on the provided scenario, you need to drop MSP and the bump it provides to ISP. You must have 8 years of medical corps service to be eligible to even sign it, and regardless of when you sign, it will add time to your obligation (unless you use that fellowship loophole that I still don't fully understand).

 

[pgg]

Based on the provided scenario, you need to drop MSP and the bump it provides to ISP. You must have 8 years of medical corps service to be eligible to even sign it, and regardless of when you sign, it will add time to your obligation (unless you use that fellowship loophole that I still don't fully understand).

His example was internship + 3 years of GMO + 3 years of residency + 3 years of payback so the example ought to be eligible for MSP.


OP, your example

$96,386.88 + ASP $15,000 + VSP $11,000 + ISP* $30,000 + MSP* $40,000 + BCP $3,500 = $195,886.88

looks right to me, though I didn't look up and check the actual values for O4 >10 no dep in Jax pay.

The clock for creditable service for pay purposes starts the day you're commissioned O3 into the medical corps after med school. If you have prior creditable service you might get O3E pay initially. But even if you have 10 years enlisted prior to med school, your VSP and BCP clock starts at zero the day you graduate from med school. USUHS years count toward the retirement multiplier after you reach retirement eligiblity not counting USUHS time. HPSP years are not creditable for anything.

 

[colbgw02]

His example was internship + 3 years of GMO + 3 years of residency + 3 years of payback so the example ought to be eligible for MSP.


OP, your example

looks right to me, though I didn't look up and check the actual values for O4 >10 no dep in Jax pay.

The clock for creditable service for pay purposes starts the day you're commissioned O3 into the medical corps after med school. If you have prior creditable service you might get O3E pay initially. But even if you have 10 years enlisted prior to med school, your VSP and BCP clock starts at zero the day you graduate from med school. USUHS years count toward the retirement multiplier after you reach retirement eligiblity not counting USUHS time. HPSP years are not creditable for anything.

I misread the OP. I thought he was asking about during his post-residency ADSO instead of after it. Sorry for the confusion.

 

[TLAD123]

His example was internship + 3 years of GMO + 3 years of residency + 3 years of payback so the example ought to be eligible for MSP.


OP, your example

looks right to me, though I didn't look up and check the actual values for O4 >10 no dep in Jax pay.

The clock for creditable service for pay purposes starts the day you're commissioned O3 into the medical corps after med school. If you have prior creditable service you might get O3E pay initially. But even if you have 10 years enlisted prior to med school, your VSP and BCP clock starts at zero the day you graduate from med school. USUHS years count toward the retirement multiplier after you reach retirement eligiblity not counting USUHS time. HPSP years are not creditable for anything.

Thank you to all for answers!

Assuming this will be a yes, but if someone has 5 years of prior service, goes to USUHS, and follow the example above, would the 5 years prior at least count toward the 20 years retirement and base pay rate? Then once 20 years is reached, one would retire with 24 years of service to include USUHS?

To the post about the loophole: it is my understanding after reading the document that if you sign a MSP, and then do a fellowship the next year, both service obligations can be served concurrently. If however you do a fellowship before MSP is signed, then one is not eligible for MSP until after the obligation for fellowship is served. So wait to do the fellowship if you can

How long is a fellowship ADSO?

 

[colbgw02]

Thank you to all for answers!

Assuming this will be a yes, but if someone has 5 years of prior service, goes to USUHS, and follow the example above, would the 5 years prior at least count toward the 20 years retirement and base pay rate? Then once 20 years is reached, one would retire with 24 years of service to include USUHS?

To the post about the loophole: it is my understanding after reading the document that if you sign a MSP, and then do a fellowship the next year, both service obligations can be served concurrently. If however you do a fellowship before MSP is signed, then one is not eligible for MSP until after the obligation for fellowship is served. So wait to do the fellowship if you can

How long is a fellowship ADSO?

Close. It's not that you're ineligible for MSP if you start fellowship before signing, it's that the obligations are served sequentially rather than concurrently. My confusion doesn't stem from that, rather what the rules are about restructuring one's bonuses around the academic year vs. the fiscal year as well as when you can sign an MSP if still otherwise obligated. I feel like the Army, at least, may have changed its rules on this recently, to which I only partly paid attention.

My understanding of all GME obligations is that it's 6 months for 6 months with a 2 year minimum.

 

[pgg]

Assuming this will be a yes, but if someone has 5 years of prior service, goes to USUHS, and follow the example above, would the 5 years prior at least count toward the 20 years retirement and base pay rate? Then once 20 years is reached, one would retire with 24 years of service to include USUHS?

Yes.

I think the only caveat is that the medical special pays which are dependent on time in service (VSP, BCP) are calculated based on med school graduation date, not original entry into service.

If those 5 prior years were enlisted, the person would get O1E pay while in school and O3E pay upon graduation.* If they were commissioned years, the person might have time credited toward O4 after graduation. One of my classmates, a prior service pilot, was selected for O4 during his intern year and put on O4 around Oct or Nov of his first GMO year, barely a year out of med school.

Also, I have read here that a (relatively) recent change is that prior service active duty personnel who go to USUHS won't get a pay cut. Previously, the O3 pilot who went to USUHS would get O1 pay after being "demoted" when starting school. Now, they retain their existing pay level while in school.


* I'm not 100% sure if that would be O1E <6yrs or O1E <2yrs ... I think it may actually be <2yrs, since my recollection is that the time-in-service pay counter starts anew at zero when you graduate from medical school. Retirement eligibility calculation certainly includes the prior enlisted service.

 

[TLAD123]

Also, I have read here that a (relatively) recent change is that prior service active duty personnel who go to USUHS won't get a pay cut. Previously, the O3 pilot who went to USUHS would get O1 pay after being "demoted" when starting school. Now, they retain their existing pay level while in school.

In my case, I would be an O3 pharmacist going to USUHS after 5 years of service (2 which count for retirement/pay while I was in school (HSCP not HPSP), and 3 as an O3 pharmacy officer). Could you please point me to where you found the information on the recent change/not getting a pay cut when going to USUHS? I always thought I would be demoted to an O1 and lose my prior commissioning. But if I could receive O3 pay at 5 years of prior service, that would be a very substantial difference! Can anyone else confirm/deny this?

And thank you for your replies. This is very helpful info.

 

[ArmyTiger]

In my case, I would be an O3 pharmacist going to USUHS after 5 years of service (2 which count for retirement/pay while I was in school (HSCP not HPSP), and 3 as an O3 pharmacy officer). Could you please point me to where you found the information on the recent change/not getting a pay cut when going to USUHS? I always thought I would be demoted to an O1 and lose my prior commissioning. But if I could receive O3 pay at 5 years of prior service, that would be a very substantial difference! Can anyone else confirm/deny this?

And thank you for your replies. This is very helpful info.

Can't speak to USUHS, but as an HPSP student, I get 1LT with <4 years pay when I'm on ADT. All I had to do was get my DA-71 made out as an O-2. May have been other changes somewhere in my packet too, but my recruiter made them, so I'm not sure. I also had to get orders amended as it's not the norm.

 

[pgg]

Could you please point me to where you found the information on the recent change/not getting a pay cut when going to USUHS? I always thought I would be demoted to an O1 and lose my prior commissioning. But if I could receive O3 pay at 5 years of prior service, that would be a very substantial difference! Can anyone else confirm/deny this?

It was discussed in this thread a few years ago when the law was changed.

More discussion in this thread.

My understanding is that ever since then, priors did not risk 'pay cuts' to go to USUHS.

 

[colbgw02]

In my case, I would be an O3 pharmacist going to USUHS after 5 years of service (2 which count for retirement/pay while I was in school (HSCP not HPSP), and 3 as an O3 pharmacy officer). Could you please point me to where you found the information on the recent change/not getting a pay cut when going to USUHS? I always thought I would be demoted to an O1 and lose my prior commissioning. But if I could receive O3 pay at 5 years of prior service, that would be a very substantial difference! Can anyone else confirm/deny this?

And thank you for your replies. This is very helpful info.

I can confirm. I knew one of the then-USUHS students who lobbied Congress to have the law altered. You'll still be re-commissioned as an O1, but you shouldn't see a pay cut.

 

[TLAD123]

I can confirm. I knew one of the then-USUHS students who lobbied Congress to have the law altered. You'll still be re-commissioned as an O1, but you shouldn't see a pay cut.

This person deserves a medal - love to hear that health care professionals are lobbying congress, even if this is non-specific to the delivery of health care. Thanks for the responses pgg and colbgw02!

 

[Perrotfish]

I'm still a little confused about eligibility. If I have a 4 year HPSP obligation, and I finish a three year residency, when am I first eligible for ISP? When can I first sign a contract for MSP?

 

[pgg]

I'm still a little confused about eligibility. If I have a 4 year HPSP obligation, and I finish a three year residency, when am I first eligible for ISP? When can I first sign a contract for MSP?

See the attached file for all the gory details.

You're eligible for ISP on October 1st immediately following your residency, unless you graduate off-cycle (before the end of June) for reasons that aren't your fault, you can get it earlier. I think the FY14 document was the first to add language stating that ISP eligiblity begins 3 months after completion of initial residency training. For most people, that'll be Oct 1st (see paragraph E6).

To be eligible for MSP, you need
- to be residency trained, AND
- have 8 years of creditable service or have completed any education obligation
You don't necessarily have to have completed your educational ADSO yet - in this case, the MSP years are just tacked on the end. (Since money now is worth more than money later, lots of people who know they'll be in for 20+ will do this.) The educational ADSO is served first, then the MSP - this may matter later for FTOS fellowship obligation calculations.

Technically MSP contract requests can be declined if the needs of the service are judged to not need it, but I've never heard of that happening. It would suck to be at year 16 and expect to get a 4-year MSP to take you to retirement, only to be told that no MSPs are being signed (but you can stay anyway to 20).

 

[Perrotfish]

See the attached file for all the gory details.

You're eligible for ISP on October 1st immediately following your residency, unless you graduate off-cycle (before the end of June) for reasons that aren't your fault, you can get it earlier. I think the FY14 document was the first to add language stating that ISP eligiblity begins 3 months after completion of initial residency training. For most people, that'll be Oct 1st (see paragraph E6).

To be eligible for MSP, you need
- to be residency trained, AND
- have 8 years of creditable service or have completed any education obligation
You don't necessarily have to have completed your educational ADSO yet - in this case, the MSP years are just tacked on the end. (Since money now is worth more than money later, lots of people who know they'll be in for 20+ will do this.) The educational ADSO is served first, then the MSP - this may matter later for FTOS fellowship obligation calculations.

Technically MSP contract requests can be declined if the needs of the service are judged to not need it, but I've never heard of that happening. It would suck to be at year 16 and expect to get a 4-year MSP to take you to retirement, only to be told that no MSPs are being signed (but you can stay anyway to 20).

Oh, wow, that's a much bigger post residency pay bump than I thought I was getting.

So can I sign for MSP the day I finish residency if I'm willing to extend my obligation? If I do that and sign for four years, do I only get paid MSP for 4 years, or do I get paid through the end of my commitment? If I did fellowship I feel like I would be willing to do the extra year for the MSP

 

[TLAD123]

Here's how I read: if you sign for 4 years MSP, you get only 4 years MSP benefit. If you want another 2, 3, or 4 years of benefit, you have to sign for another 2, 3, or 4 years, respectively. So, if you sign it right after residency, and if you did a 3 year residency, you will have 3 years of ADSO after MSP stops. You can sign again, but it adds on the respective ADSO to your 3 years. Regardless, you will have 3 years to serve without MSP if you sign right after residency and had a 3 year residency. Same principle for longer residencies (4 year residency, 4 years without MSP). You do get ISP during that time though, so that's better than nothing.

Also do your fellowship after your MSP is signed and complete it before it is up. Then you won't tack on additional ADSO for the fellowship and get paid MSP.

 

[TLAD123]

An eligibility question I've come up with:

For USUHS folks - What counts toward the 7 year commitment?

Say immediate internship then residency followed (say 4 years total). Do these count toward the 7 years?

For MSP/ residency commitments. Is residency commitment served concurrently with USUHS? Is MSP served concurrently with USUHS?

I apologize if this is naive and simple.

 

[pgg]

Oh, wow, that's a much bigger post residency pay bump than I thought I was getting.

So can I sign for MSP the day I finish residency if I'm willing to extend my obligation? If I do that and sign for four years, do I only get paid MSP for 4 years, or do I get paid through the end of my commitment? If I did fellowship I feel like I would be willing to do the extra year for the MSP

If you have the 8 years, you can sign MSP on Oct 1st, three months after you finish residency (it's tied to ISP so that fiscal year nonsense applies). Of course you actually do the paperwork and physically sign it before that, but it's dated and will go into effect Oct 1st. Also, be aware, that each year MSP/ISP are notoriously late. Sometimes the instruction doesn't come out until December ... they always backdate the paperwork and the obligation period to start Oct 1st, but you might not get paid until Nov or Dec.

If you sign the MSP contract while you still have an educational ADSO in effect, you'll get the MSP for just the next 2-4 years. After that, there is still obligated service remaining, during which you do not get MSP, just regular ISP.

An eligibility question I've come up with:

For USUHS folks - What counts toward the 7 year commitment?

Say immediate internship then residency followed (say 4 years total). Do these count toward the 7 years?

Time not in internship or residency count toward USUHS payback. Intern year is dead time - it neither adds to any obligation, nor pays back any time. Residency incurs a 1:1 obligation, but this is served concurrently with USUHS or HSPP obligation. Eg,

graduate USUHS 2014 - owe 7 years
finish internship 2015 - owe 7 years
finish residency 2018 - owe 7 years from USUHS, 3 years from residency
staff tour 2019 - owe 6 years from USUHS, 2 years from residency
staff tour 2020 - owe 5 years from USUHS, 1 year from residency
staff tour 2021 - owe 4 years from USUHS
staff tour 2022 - owe 3 years from USUHS
staff tour 2023 - owe 2 years from USUHS
staff tour 2024 - owe 1 year from USUHS
staff tour 2025 - no obligation

Throw in a GMO tour:

graduate USUHS 2014 - owe 7 years
finish internship 2015 - owe 7 years
finish GMO tour 2018 - owe 4 years
finish residency 2021 - owe 4 years from USUHS, 3 years from residency
staff tour 2022 - owe 3 years from USUHS, 2 years from residency
staff tour 2023 - owe 2 years from USUHS, 1 year from residency
staff tour 2024 - owe 1 year from USUHS
staff tour 2025 - no obligation

And for the HPSP'ers ... the possibility exists that inservice residency will extend your overall ADSO:

graduate HPSP 2014 - owe 4 years
finish internship 2015 - owe 4 years
finish GMO tour 2018 - owe 1 year
finish residency 2021 - owe 1 year from HPSP, 3 years from residency
staff tour 2022 - owe 2 years from residency
staff tour 2023 - owe 1 year from residency
staff tour 2024 - no obligation


/ edited for typo and to add HPSP example

 

[TLAD123]

As always, thanks pgg.

 

[Mace1370]

pgg, I think that is slightly off. While in residency you are paying off your USUHS debt, but incurring residency debt. These debts are not paid off concurrently after residency is over. The result is the same (owe 3 USUHS, 4 residency).

 

[pgg]

pgg, I think that is slightly off. While in residency you are paying off your USUHS debt, but incurring residency debt. These debts are not paid off concurrently after residency is over. The result is the same (owe 3 USUHS, 4 residency).

You're saying (?) this -

                      USUHS               HPSP
graduate      2014    owe 7               owe 4
finish int    2015    owe 7               owe 4
finish res    2018    owe 4 (U), 3 (R)    owe 1 (H), 3 (R)
              2019    owe 3 (U), 3 (R)    owe 0 (H), 3 (R)
              2020    owe 2 (U), 3 (R)    owe 2 (R)
              2021    owe 1 (U), 3 (R)    owe 1 (R)
              2022    owe 0 (U), 3 (R)    owe 0 (R)
              2023    owe 2 (R)
              2024    owe 1 (R)
              2025    owe 0 (R)



                      USUHS               HPSP
graduate      2014    owe 7               owe 4
finish int    2015    owe 7               owe 4
GMO           2016    owe 6               owe 3
GMO           2017    owe 5               owe 2
GMO           2018    owe 4               owe 1
finish res    2021    owe 1 (U), 3 (R)    owe 0 (H), 3 (R)
              2022    owe 0 (U), 3 (R)    owe 2 (R)
              2023    owe 2 (R)           owe 1 (R)
              2024    owe 1 (R)           owe 0 (R)
              2025    owe 0 (R)

Interesting -

I've always heard it explained that USUHS/HPSP obligations were servec concurrently to each other, and that time in residency didn't pay off USUHS/HPSP, but I guess the math works out the same.

 

[sonofva]

Can I ask why GMO is calculated as 3 years? I thought they were only 2...

 

[pgg]

Can I ask why GMO is calculated as 3 years? I thought they were only 2...

It varies ...

In the Navy, flight surgery and dive GMO tours are always 3 years, though HPSP'ers often extend to 4 and get out for civilian residencies. Marine or ship GMO are generally 2. There are (were?) rare unaccompanied GMO tours that were just 1. Back in the day I knew a couple Army guys who did 1-year GMO tours in Korea. No idea what the AF does but I think they're mostly 2.

 

[TLAD123]

I did think of another question that may be beneficial info for those seeking fellowship and MSP, but I answered myself by reading the document posted above.

Will continue to use the above example by pgg.

Say you still have education ADSO to serve yet, but you sign the MSP early before that is up. So in the first example, if MSP signed 2018 so one can start receiving the pay, the ADSO for MSP would not start until 2025 (after USUHS and residency educational ADSOs are paid back). Would someone interested in fellowship be eligible for the MSP/fellowship loophole if they complete the desired fellowship before the obligatory period 7 years later, or would they need to wait until after the obligation period starts in order to be eligible?

Answer:

"If the member does have pre-existing obligation for education and training and the member takes an MSP prior to entering a fellowship the MSP obligation will be consecutive with the pre-existing obligation, but concurrent with the fellowship training and obligation."

So MSP and fellowship ADSOs would be served concurrently (at the same time), consecutively with (right after) the ADSO for education (USUHS/Residency).

Hope that helps someone.

 

[colbgw02]

I've always heard it explained that USUHS/HPSP obligations were servec concurrently to each other, and that time in residency didn't pay off USUHS/HPSP, but I guess the math works out the same.

This is correct. I used to think it was the other way - that you were paying off HPSP time in residency while simultaneously incurring GME commitment - but that's not correct. You don't go into payback for any obligation until you are out of training.

 

[denali]

This is correct. I used to think it was the other way - that you were paying off HPSP time in residency while simultaneously incurring GME commitment - but that's not correct. You don't go into payback for any obligation until you are out of training.

Concur. I'm looking at my ADSO Worksheet from MODS and my ADSO end date was calculated by totaling up my training obligation (USUHS + residency), adding that to the date I graduated residency, then subtracting off the sum of my concurrent residency obligation and 40 days on AD between USUHS grad and Jul 1 residency start.