Military doctors who are now civilian doctors, what was the transition like after being discharged?

[Beneath the marquee]

How would you describe your experience of making that transition from Army/Navy/Air Force back into the civilian world? If you were an HPSP student, what was the best/worst part of the transition? Was it difficult?

Also what do you specialize in now?

---

Members don't see this ad.

 

[HighPriest]

Like seeing sunshine for the first time.

It was beautiful and there was so much you didn’t even realize you were missing, and it was a little uncomfortable at first, but you wouldn’t go back in the hole for anything.

Best part of the transition: I haven’t done online training in three years.

Worst part: all the stupid hoops you have to jump through and all of the lost paperwork and the 8 week delay in receiving my HHG. Basically, all the usual Army things.

I specialize in the same thing now that I did in the Army, except I can actually practice the whole breadth of my field now.

 

[Monty Python]

Best part of the transition: I haven’t done online training in three years.

Want to go have lunch?

 

[HighPriest]

Want to go have lunch?

View attachment 312033

That @$&! is nothing but bad news, man. Don’t listen to anything she says.

 

[pgg]

That @$&! is nothing but bad news, man. Don’t listen to anything she says.

I always try to get that training 100% wrong. I make very bad decisions and try to help the adversary.

It's harder than you might think to get it all perfectly wrong.

 

[HighPriest]

I always try to get that training 100% wrong. I make very bad decisions and try to help the adversary.

It's harder than you might think to get it all perfectly wrong.

Just do what Tina tells you. It’s a spring board to failure.

 

[armytrainingsir]

Want to go have lunch?

hahahahahahahaha

 

[Gastrapathy]

In your last year, Getting every badge and highest score you can on the training is the other way to go. Then it can be the second line in your final fitrep right after “out processing SME: set the standard by which all future check outs will be measured”

 

[WernickeDO]

How would you describe your experience of making that transition from Army/Navy/Air Force back into the civilian world? If you were an HPSP student, what was the best/worst part of the transition? Was it difficult?

Also what do you specialize in now?

The only difficult part of transitioning out is trying to get people to do their job. Paperwork getting lost/messed up/forgotten about it the standard.

I'm an emergency doc now.

Basically every other aspect of civilian life is better. I actually sat here for a moment trying to think about anything I miss about military life, and I miss some of the people and friendships I made, but the friendships I've made in my civilian gig makes up for it.

I had spent the majority of my adult life as a civilian. I was active for 5 years. I imagine the transition is more difficult for those who have spent their adult years active duty.

I'm proud to have served but glad I'm out.

 

[MHYDE]

I transitioned out from an overseas base. The month I spent back in the states trying to get someone - ANYONE - from finance or MPS on the phone to process my travel voucher and help me with my HHG, and I couldn't just walk over there and talk to them directly, geez... Did you know that in the civilian world, when you call an office and nobody's there, you can leave a message, and they call you back? The Air Force apparently hasn't gotten voicemail yet.

No computer training and no quarterly awards and no murder boards and NO MORE OPR'S. Out here, when you are evaluated or you evaluate others, it takes a few minutes (not three months!) and is generally truthful and helpful feedback (not gibberish!) and if you get an award it kind of means something, not just that it was your turn! So many hours wasted on those things. I think maybe that's just an AF thing?

Contrary to someone above, I think I got to practice a broader scope of medicine in the AF than I did when I got out, and our techs/nurses were (mostly) really capable and eager. After I got out I did civilian primary care pediatrics for a year before I got really bored and decided to do a fellowship.

Footnote: you can use your GI Bill benefits to supplement your income during fellowship! That made the decision a lot easier.

 

[IlDestriero]

In a word, glorious.
The transition wasn’t difficult at all.
I wouldn’t be able to do what I wanted in the .mil.
I got out and used my GI bill for fellowship training as well.
I’m a Pediatric Anesthesiologist.

 

[armytrainingsir]

AD to civilian?
Easy.
More money, for sure.
Headaches are still there, they are just different and have a new name or source.
Being able have the final word and just say 'No' is priceless.
Only downside I had personally is the realization you're not in the 'club' anymore. They take away your membership card. A bit sad because I had some great times on AD and made lifelong friends; overall more good than bad. But my AD time was a different era, so YMMV

Now, Im back in the reserves, and get to enjoy the aspects of military medicine I liked, but the light at end of the tunnel (ie civilian life) never goes out.

 

[orbitsurgMD]

The transition was a huge relief, even though it was to PGY2. I got to do a fellowship when I wanted, not when someone whose foremost interests were not mine wanted. I have never regretted getting out nor wished to go back. The Navy experience wasn't all bad, but it certainly wasn't all good. They paid for med school and got their service back in return. If I could have done it without the GMO time (as a flight surgeon) I probably would have been happier with the experience, or maybe not. Knowing what I know now, I definitely would try to use some other education-for-service option besides HPSP, especially as things are now.

 

[Gastrapathy]

Brooks was here

 

[HighPriest]

Brooks was here

Yeah but Andy Dufresne crawled through a river of $#!t and came out clean on the other side. I think I’m more of an Andy than a Brooks.

 

[IlDestriero]

Yeah but Andy Dufresne crawled through a river of $#!t and came out clean on the other side. I think I’m more of an Andy than a Brooks.

Yes, definitely Andy. Brooks is the ortho surgeon that gets out after 20 years and comes back as a civilian contractor or goes the VA when his 3 hour knee scopes at the nice suburban hospital draw friendly fire.

 

[j4pac]

Better support...no question.

The patient population...worse

 

[absolutdokta]

Throwing together my UQR packet right now. A couple more counselings and signatures and she’ll be good to go. Can’t believe i reached this point in time from when I got word I was approved (awarded? lol) my HPSP contract.

Still mulling over the reserves as an option....sure would be nice to leave all the shenanigans behind. But health insurance for the fam and retirement also sound nice.

 

[d2305]

No one watches me pee now.

 

[HighPriest]

No one watches me pee now.

Not for free, no.

 

[HighPriest]

Better support...no question.

The patient population...worse

Patient pop is worse. No way around that. Don’t get me wrong, not everyone is bad. And some of the worst patients I have even now are military family members who can’t understand why you don’t worship their medical complaints. But statistically there are more bad patients on the civilian side. More people with drug problems. More old people with problems that simply can’t be fixed. Working with soldiers was great. Generally healthy people who generally want to get back to normal. There are civilian versions too, just fewer. And I’m sure that’s very specialty dependent. I imagine if you’re a dermatologist it’s more similar (but busier) and if you’re in the ED it’s probably far worse when you’ve got meth heads, etc.

 

[armytrainingsir]

Still mulling over the reserves as an option....sure would be nice to leave all the shenanigans behind. But health insurance for the fam and retirement also sound nice.

Critical Wartime specialty?
How many years AD do you have?
What is your specialty's deployment tempo?
How many years HPSP?


Every good year in the Reserves and the army will pick up a year of HPSP and make it a good retirement year as well. So 4 years of HPSP and 4 good years in the reserves will get you 8 good retirement years.

You can get your 20 year letter at year 16.

Reserves isn't for everybody, but it has worked well for me. YMMV.

 

[absolutdokta]

Critical Wartime specialty? Yes (unless fam med was pulled off that Dec 2019 list)

How many years AD do you have? Seven when all is said and done.

What is your specialty's deployment tempo? Honestly don’t know. I guess it just depends on the unit? One of my classmates has been deployed twice (rangers), another once, another yet to be.

How many years HPSP? Four

 

[armytrainingsir]

absolutdokta,

You would need 9 years in the reserves to be able to retire.
7 years AD + 9 good years in the reserves+ 4 years of HPSP that will magically appear when you have done 4 years in the reserves=20 year letter.
You would eligible sign a 1-4 year retention contract if you want for a bonus payment of 25K each year in addition to your drill pay.
They have added your specialty bonus to drill pay now. take whatever your FP bonus is now and you get 4/365th of that every drill weekend.
My guess is CCC is the only PME you would need to make 05
OP tempo and deployment is the biggest worry due to the disruption in your civilian career. Some jobs are tolerant of that, some aren't. YMMV.
Tricare Reserve Select is about $215 per month for your family. Has worked well for me and my family the past 5 years.

SWAG on your retirement: guessing on retiring as 05 with 3500 points, turning 60 in 2045: somewhere around $3500 per month, starting at age 60, for life and Tricare for Life (think of as a cheap/free Medicare supplement) But who know what tricare or medicare would look like then.

the above is based on my experience. YMMV.

also, sent you a PM

 

[Perrotfish]

absolutdokta,

You would need 9 years in the reserves to be able to retire.
7 years AD + 9 good years in the reserves+ 4 years of HPSP that will magically appear when you have done 4 years in the reserves=20 year letter.
You would eligible sign a 1-4 year retention contract if you want for a bonus payment of 25K each year in addition to your drill pay.
They have added your specialty bonus to drill pay now. take whatever your FP bonus is now and you get 4/365th of that every drill weekend.
My guess is CCC is the only PME you would need to make 05
OP tempo and deployment is the biggest worry due to the disruption in your civilian career. Some jobs are tolerant of that, some aren't. YMMV.
Tricare Reserve Select is about $215 per month for your family. Has worked well for me and my family the past 5 years.

SWAG on your retirement: guessing on retiring as 05 with 3500 points, turning 60 in 2045: somewhere around $3500 per month, starting at age 60, for life and Tricare for Life (think of as a cheap/free Medicare supplement) But who know what tricare or medicare would look like then.

the above is based on my experience. YMMV.

also, sent you a PM

Is FM still on the critical wartime specialties list? I know they dropped Peds from the list, and my understanding is that if your specialty isn't on the list then HPSP years don't count towards retirement.

 

[d2305]

Defense Finance and Accounting Service > MilitaryMembers > payentitlements > Pay Tables > HPO2

 

[armytrainingsir]

Is FM still on the critical wartime specialties list? I know they dropped Peds from the list, and my understanding is that if your specialty isn't on the list then HPSP years don't count towards retirement.

It is my understanding that FM is still on the CWSL. And you are correct that only applies to those specialties. Thanks for the clarification..

Here is the original DoD instruction, which was still if full force for me in Jul 18 ( got my HPSP credit), and it worked for a dental officer buddy just a few months ago.

 

[Mt Kilimanjaro]

What all is required for a "good year" in the reserves. I've looked at this a little bit but the points and requirements quickly confuse me. Say I'm IMA in my specialty, what all is required in the course of a year to have it count towards a reserve retirement?

Thanks for the detailed responses.

absolutdokta,

You would need 9 years in the reserves to be able to retire.
7 years AD + 9 good years in the reserves+ 4 years of HPSP that will magically appear when you have done 4 years in the reserves=20 year letter.
You would eligible sign a 1-4 year retention contract if you want for a bonus payment of 25K each year in addition to your drill pay.
They have added your specialty bonus to drill pay now. take whatever your FP bonus is now and you get 4/365th of that every drill weekend.
My guess is CCC is the only PME you would need to make 05
OP tempo and deployment is the biggest worry due to the disruption in your civilian career. Some jobs are tolerant of that, some aren't. YMMV.
Tricare Reserve Select is about $215 per month for your family. Has worked well for me and my family the past 5 years.

SWAG on your retirement: guessing on retiring as 05 with 3500 points, turning 60 in 2045: somewhere around $3500 per month, starting at age 60, for life and Tricare for Life (think of as a cheap/free Medicare supplement) But who know what tricare or medicare would look like then.

the above is based on my experience. YMMV.

also, sent you a PM

 

[armytrainingsir]

50 points is a good year.

Everybody gets 15 points given to them per year. They are prorated, so if you get out (retire or ETS) your 15 points are prorated.

One day on AD orders = 1 point.
So you get 14 points for your two weeks of training ( AT, annual training, almost always done in late June or July)
Get orders to teach ATLS? one point per day of orders

Battle Assembly, BA, ie weekend drill
You get 1 point for each four hours/ half day also called MUTA or Multiple Unit Training Assembly. Max is 2 per day, even if you work 12 hours or are in the field 24 hours
so, one weekend, 4 MUTAs, = 4 points
Most units will have one or two 3 day or 6 MUTA BA throughout the year and skip one other month

Going to annual dental appointment is 1 point.
Going to PHA, one point.

Deployment/MOB is one point per day since you are on AD orders

CME one point per day for in person CME (6 hours is minimum for it to count)

My unit will give you 2 MUTA for doing your annual online training on your own time

There are other ways to earn points, but the army for sure has been cracking down on these and there are fewer and fewer ways to earn a point it seems.


Theoretical/typical points per year
15 points for being in the reserves
14 points for going to AT
48 points for going to BA once per month
1 point for PHA
1 point for dental
So that's 79 points.

IME, there is almost always something that 'comes up' and you get on orders for a few days here or there. As part of APMC, they want us to fly to Atlanta for a meeting for a few days every year. That's 2-3 points. I got a CME funded last year and was on orders for 4 days, 4 points. CME on my dime at annual meeting, 5 points. Going to ATLS instructor class at Ft Sam, 4 points.

Likewise, vacations, life, real job commitments also get in the way and you miss a few BAsor even some/all of your 2 week AT.


Hope the above helps and is based on my experience these last 5.5 years.

 

[Monty Python]

50 points is a good year.

Everybody gets 15 points given to them per year. They are prorated, so if you get out (retire or ETS) your 15 points are prorated.

One day on AD orders = 1 point.
So you get 14 points for your two weeks of training ( AT, annual training, almost always done in late June or July)
Get orders to teach ATLS? one point per day of orders

Battle Assembly, BA, ie weekend drill
You get 1 point for each four hours/ half day also called MUTA or Multiple Unit Training Assembly. Max is 2 per day, even if you work 12 hours or are in the field 24 hours
so, one weekend, 4 MUTAs, = 4 points
Most units will have one or two 3 day or 6 MUTA BA throughout the year and skip one other month

Going to annual dental appointment is 1 point.
Going to PHA, one point.

Deployment/MOB is one point per day since you are on AD orders

CME one point per day for in person CME (6 hours is minimum for it to count)

My unit will give you 2 MUTA for doing your annual online training on your own time

There are other ways to earn points, but the army for sure has been cracking down on these and there are fewer and fewer ways to earn a point it seems.


Theoretical/typical points per year
15 points for being in the reserves
14 points for going to AT
24 points for going to BA once per month
1 point for PHA
1 point for dental
So that's 55 points.

IME, there is almost always something that 'comes up' and you get on orders for a few days here or there. As part of APMC, they want us to fly to Atlanta for a meeting for a few days every year. That's 2-3 points. I got a CME funded last year and was on orders for 4 days, 4 points. CME on my dime at annual meeting, 5 points. Going to ATLS instructor class at Ft Sam, 4 points.

Hope the above helps and is based on my experience these last 5.5 years.

If doing all 12 monthly drill weekends with no absences, where you earn 1 point per 4 hour block at drill, wouldn’t that be 48 points versus 24?

 

[armytrainingsir]

If doing all 12 monthly drill weekends with no absences, where you earn 1 point per 4 hour block at drill, wouldn’t that be 48 points versus 24?

Duh.
You are correct.
Fixed.

I knew something was wrong, because there is way more wiggle room than just 5 points per year.

 

[GreenHousePub]

I'm assuming no, but do they add the board certification pay to drill pay?

 

[armytrainingsir]

I'm assuming no, but do they add the board certification pay to drill pay?

New in 2020, both board cert pay and specialty pay are paid, prorated. Each 4 hours of drill, you get 1/365th of both specialty pay and board cert pay. For most surgeons, that is an extra $650 or so per drill. You have to execute a separate contract for that, but there is no extra obligation, just that you meet the qualifications for the pay.

 

[premedjunky]

Just came across this thread. Currently considering the HPSP program. Is there anyone I can message regarding a couple questions? Thanks!

 

[pgg]

Just came across this thread. Currently considering the HPSP program. Is there anyone I can message regarding a couple questions? Thanks!

Post them here. That's what the forum is for.

 

[DOswag]

Good to read positive experiences with transitioning out. I'm currently 2.5 years into my 4 year commitment. I'm counting down the days until separation. It hasn't all been bad. Residency training was split mil/civilian so I got to see both prior to being full time AD. Now that I'm full time AD, transitioning to civ side can't come fast enough. Overall I've enjoyed some aspects of being military but as said above, knowing what I know now, I might strongly consider other options to pay for med school for obligatory service...

For those considering HPSP, it's much more than "they pay for school and you pay them back service". That pay them back part can be soul crushing. Depends on what specialty you're in too. You'll be expected to care for patients within your scope certainly. But there is considerable admin/trainings/military BS/officership that you are expected to manage, complete, or just suck it up and endure; while also likely being paid significantly less than your civilian counterparts, with the expectation of picking up and moving every 3-4 years, with the potential of being tasked with a deployment. Much of what I do is occupational med as well as we are constantly having to think about the impact on someone's ability to perform their duties, are they world wide qualified, if their condition is impacting their ability to peform their duties, should we make the recommendation for a med board, or recommend administratively separating someone? Sq or Grp leadership may be good, or it may be unsupportive. Is your SGH supportive? The politics with people wanting to make rank as opposed to actually improve things can be frustrating especially if you're not into playing the politics games. Ultimately, the question should not be about the military's ability to pay for your school. Do you want to be an officer in the military or not? If you can say without question or hesitation yes, then go for it. If you are convincing yourself that you want to because the thought of having less or no debt is appealing, then I strongly urge to look deep at what you're getting yourself into as you are potentially setting yourself up for a lot of unnecessary frustration and sacrifice.

 

[DOswag]

I realize I didn't list my specialty. I'm a psychiatrist for the good ole USAF

 

[DocSurgeon]

Oh man I've been waiting to write this post for years. It's amazing. Former USAF General Surgeon, HPSP, did civilian residency, gave the government my pound of flesh and split. I definitely felt nervous getting out and working in a civilian institution at first but it didn't take long to become comfortable again. I had a pretty good run in the military, better than most, but definitely would not do it again if I could go back. Some of the advantages of getting out:

• More cases performed in my first four months out than my last 18 months in
• Similar work/life balance with 2.5x the pay and a consistent, predictable schedule (not counting the unpredictability of call shifts of course) without the last minute TDY, deployment nonsense
• Civilian administration that bends over backwards to help you succeed (in surgery!)
• Office staff that schedule my surgery, contact consultants for medical/cardiac clearance, educate patients on pre-op protocols (i.e. bowel prep, ERAS, etc), contact patients with routine lab/diagnostic/path results, fill out any and all patient forms (insurance, FMLA, work notes, etc)... I could go on. This is one of the greatest advantages I've experienced so far.
• Lack of uninterested and inexperienced 18 yo scrub and endo techs
• Epic
• Ability to leave town for the weekend and not be AWOL

How did I prepare for separation? As soon as I could I did as much moonlighting as I could. Multiple agencies. In town. Out of town. Weekends. Holidays. Whatever I could do to keep my surgical skills from dying on the vine. Worked on my CV throughout the year and took leadership opportunities that would pad it for once I got out. And I will say this; I definitely got my foot into the door of multiple interviews because of my military experiences. Jobs that I would have had no chance straight out of residency. That would probably be my biggest piece of advice for all ya'll still tethered to the .mil ball and chain - take advantage of the system where you can and use it to your advantage.