Hey everybody,
I've been quite interested in the Army HPSP for two years now, and in that time have done my best to educate myself regarding the choices that I face. What follows is a somewhat lengthy (and hopefully helpful) compilation of my findings and comments (in no particular order).
I have to concur with all of the statements made previously by prior military/current HPSP students. Although this sounds weird, you'll find that the majority of HPSP students do NOT know what they've signed on for (and thus are setting themselves up to be unhappy??).
Second, the myth that "dumb" people consider (I've heard this elsewhere) this is patently absurd. At any top institution, you will find (verify this by checking residency placements as only HPSP kids can attend military residencies) at least one or two students entering one or more branches of the military. During my visits to Vandy and Emory just recently this was confirmed because at each school there were HPSP students. So, with that little factoid, it seems reasonable to assume that your potential future colleagues will be top notch.
Third, and this is my conclusion from reading articles, talking to former service docs and even COL Maschette (deputy head of the Army HPSP..and incidently a great person to talk to about any doubts you might have, or to verify what your recruiter is telling you) is that YOU SHOULD NOT BE IN THIS ONLY FOR THE MONEY. What is sad is that the recruiters mostly sell it like that...but I'd be willing to bet on one's eventual misery if they walked down the military medicine path with the mirage of a pot of gold staring them in the face. Personally, I'm going to do it because I want to serve my country, jump out of airplanes and get a good education (oh yeah, and the money doesn't hurt). It's so important not to do this only (or primarily for the money) because you give so much up (location, possibly specialty and maybe even catching a bullet or a bomb).
Fourth, the training is generally very good. I'm very interested in orthopaedics, and fortunately the Army is very good at this particular area. Look at the board pass rates for Madigan, Tripler and Walter Reed....all 96%+. That's on par with the best in the nation. There are, however, specialties that are not the best because of the nature of the beast. For instance, I wouldn't personally choose to do a trauma surgery res. inside any branch because none of them see enough. Yes, I know that Brooke is a trauma 1, but so what?? It's not a Grady or a Cook County, that's for sure. Also, as it pertains to the "healthier patient" comment from before: despite the diversity of the patients inside the military, they are not indigent, and therefore you will miss seeing a lot of diseases that you may encounter later in your career. Bottom line: have some idea of what you'd like to do and see if the military is any good.
Lately, at least the Army, has been moving towards putting people straight into residency programs after medical school. This is a double edged sword. One former Army orthopod I wrote to said that his fav. memories of the Army were while a battalion surgeon for the Rangers. That's a GMO ONLY position. If you're into the "blowing stuff up" catagory, those positions are generally only for GMOs. However, there are exceptions like the Army Forward Surgical Groups which are the closest any Boarded doc is going to get to combat...and they're pretty close.
Also worth noting are that docs can get some of the "fun" military schooling (
http://books.army.mil/cgi-bin/bookmgr/BOOKS/P351_4/CCONTENTS) that the combat arms people get. This is, again, only for some people. Docs do go to air assault/ airborne schools, and some are special ops or ranger tabbed. You might even run across a "marksman" doc or one with an EFMB (
http://www.cs.amedd.army.mil/dts/efmbhome.htm). If you're wondering what the career lifecycle might be like:
http://www-perscom.army.mil/OPdc/DCLCYC.HTM . Like most parts of the military, it can be high-speed if you so desire (it just can't be TOO high speed).
One side note regarding residencies: there are ways to get out of having to do a military residency. Though less than scrupulous, they are legal and basically involve not filling out paperwork/showing up to interviews. Some people are really afraid of not having a civilian choice, but it stands to reason that a fairly easy way to ensure your civilian choice would be to list very difficult residency programs and just fail to match. I personally know one internist who did this, and it worked for him. However, be reminded that you will NOT be getting out of your statutory obligation to the Army for 4 years of active service. But, to be honest...if you really want to pick your training ground just do FAP.
Oh, that wonderful retirement everybody keeps talking about is roughly half of your ending BASE pay. Somebody posted a PDF of the pay grades...use ONLY that. MSP and board pay don't count in the retirement equation (at least as far as I've heard). So, if you retire at COL, it's a descent amount but nothing commensurate with your previous active duty pay.
As far as promotion is concerned for those who are at least playing with the idea of a career: the AF is the smallest and the Army is the largest. Therefore, there are the most Generals and COLs running around in the Army. HOWEVER, this doesn't mean that there are a lot. A very large medical center might be commanded by a Lt. Gen (like Tripler, I believe), but there are very few centers this big. So, one could very easily spend their entire career in the Army and never earn a star. Also be forewarned that the higher in rank one gets, the less they act like a doctor and the more they act like an administrator. The civilian sector mirrors this sometimes, but just be forewarned. The Army generally will rip you away from the OR (or burden you down with admin responsibilities) as you increase in rank (this is another reason people leave). Like most things in the Army, this two has a good side: civilian hospitals will love you for your metric based management style...and the armed forces DO love their metrics.
Medical conditions and physical fitness:
For those who don't know, you have to go through MEPS and it sucks. I was a USMC Officer Candidate once upon a time and therefore have had to endure the agony twice. Yes, you have to turn your head and cough...yes, you have to have somebody watch you pee into a cup and yes you have to get stuck with a needle. However, since HPSP kids are not combat arms, there is no EKG (yay). So, if you have a minor heart condition but are still OK to run and work out hardcore, it won't come up and you may not even have to disclose it. There is also no maximum eye prescription limit (within reason, like below 10 diopters or something, and 1 whatever the unit is of astigmatism). This was an issue when I was considering the USMC (and ultimately DQed me) but it wasn't a problem with the HPSP. I did have to get an eye consult (read: outside eye exam for exact prescription numbers), but that was it. If you've had broken leg/foot bones or other major bone breakages you'll need an ortho consult. Basically, the consult is just to make sure you're OK. Even though MEPS is designed to get rid of people, the Army and Navy (and AF to a lesser degree) really want you as a doc, so they will bend the rules somewhat. I'm not sure about colorblindness, but I don't remember doing the "lantern" test or the hidden number test with the Army physical (though I did have to take them with the USMC physical, so Navy might require them).
So, that's a whole lot of typing in a really disordered mess...but maybe (hopefully) it will help somebody. I do know more, but I just wanted to hit on some key ideas. I'll do my best to answer any questions anybody has. Best of luck with your decisions!
Sincerely,
Neil
Useful websites:
Need to find that mysterious AR ???-???:
http://www.adtdl.army.mil/atdls.htm
http://books.usapa.belvoir.army.mil/cgi-bin/bookmgr/Shelves
Read about OBC:
http://www.cs.amedd.army.mil/obchome
Why Military medicine is bad (get all the opinions):
http://semmelweissociety.tripod.com/dueprocessoflawinpeerreviewandmedicine/id51.html
http://www.usmedicine.com/article.cfm?articleID=60&issueID=16
http://www.usmedicine.com/article.cfm?articleID=61&issueID=16
The caveats, of course, to the above articles are:
a) GMO tours are on their way out, esp. in the Army/AF (this could be good or bad dep. on your perspective).
b) Whiners tend to post more often, and with more vigor, than happy people.
c) Military medicine is changing...supposedly for the better.
Items that should be considered "true" or valuable from the above sources:
a) All branches of the military hemorrhage mid-grade officers (i.e. the bread and butter of the medical corps).
http://www.usmedicine.com/column.cfm?columnID=16&issueID=12 Why? Mostly because of money and a lack of fulfillment. Esp. for surgeons, 120k pales in the face of 300k or 600k salaries.
