Military route after medical school?

[spacemanspiff17]

Hey everybody,

I will be attending medical school this upcoming fall and I have been looking at different routes for paying for this next excursion in my life. I have always wanted to do the military route, but I wanted to ask anybody who was doing it whether or not it was working out for them. If I do it, I will probably go Air Force route. Any input would be greatly appreciated, thanks-

spacemanspiff17

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[Galo]

Spaceman, this is almost a weekly question. You really need to spend sometime reading this forum, especially some of the stickies.

However, if you are doing it for the money, it is the singular worst reason to do it. You also have to know that you may not be able to choose your specialty, and may have to spend up to 2 yrs as a General Medical Officer, or a Flight Surgeon, both which you do not do a residency for. There are multiple current problems with military medicine, and many of them have been elucidated here on this forum.

Do some research and let us know what you think.

 

[Perrotfish]

To sum up what I've read on the forum:

-Most people on this forum don't like military medicine. No one likes AF military medicine. I've gotten significantly better reactions from former milimed doctors I've talked to in person (not through recruiters) but I've been assured things have gotten worse since they got out. Even in that case, no one likes AF medicine.

- You need to be doing this for more than financial reasons

- You need to be aware that joining the military can, depending on what field you choose, negatively impact your chance of getting a residency, or even outright prevent you from getting a residency.

- You need to be aware that if you want to do a civilian residency you may not be allowed to, even if you match in, even if they can't offer you a slot in the same field.

-You need to be aware that you can't quit, even if you're willing to pay back all the money you owe plus interest.

-You need to be aware of the opportunity costs involved here. The payout from the scholarship is constant, the opportunity cost depends on your chosen profession. If you go into internal medicine at the end of your obligation you might be up several hundred thousand compared to your civilian colleagues, if you get into neurosurgery you could lose millions.

Why I'm doing it anyway:

-First and foremost, the aforementioned patriotic guilt complex that will follow me for the rest of my life if I don't do this

-Self centered gunnerism seems much less prevelant among milimeds that the civilians at the school where I'm doing my SMP.

-The money might be less than the opportunity cost, but its none the less significant. I'm going to be at an expensive school, they pay 35K a year of medical school on top of the fees and tuition (factoring in bonus and ADT) and their residencies pay a LOT more (assuming I get one, of course). Also, to be honest with myself, I'm not going to be a neurosurgeon, I have enough trouble not butchering the freakin' cadaver. I'm currently thinking EM, which would be a little worse than financially neutral compared civilian, or IM, which would be a significant gain.

-Money now does not equal the same amount of money (even with interest) later. As long as I'm on loans I'm going to be tied financially to my family.

Anyway, best of luck with your decision.

 

[sethco]

So Perrotfish, here is what I don't understand...

You state that you should not be doing this for the money, yet 2 out of your 4 reasons why you are doing the scholarship revolve around money. Isn't that slightly hypoocritical (sp)?

My main complaint isn't with AF medicine. In fact, I actually like my job as a flight surgeon. Sometimes, it can be a pain in the a** and I realize it is delaying me from finishing residency, but I really feel like part of the team and that I am getting great satisfaction from serving my country.

No, my main complaint is with the lies the HPSP program propagates. If I could do it all over again (assuming I still went the military route, which I would not BTW), I would have just taken out loans during med school and took the PAP scholarship, so I could pay back the med school loans. The main difference that people forget about all the time, is you already have the residency of YOUR CHOICE (Both specialty and location). Your commitment is nearly identical to the HPSP program.

However, given all that I completely agree with the above posters. Although, most people take the HPSP scholarship for the money (despite what anybody claims, this is the main reason), there could not be a worse reason. I will be the first to admit that I took the scholarship solely for the money and did not realize what I was getting myself into. Ahhhhhh, hindsight is...well you know the rest.

Just my 2 cents.

 

[Perrotfish]

Actually what I said is that if you're doing it solely for the money you're doing it for the wrong reasons. I'm not doing it solely for the money, and I would do it for a significant financial loss. That doesn't mean I don't consider the money, or that I would do it regardless of the magnitude of the financial loss. There do need to be some benifits to make up for the lost pay after residency and the risk of not getting my residency of choice. It's like your girlfriend's body: not enough for a relationship in and of itself, but that doesn't mean its not a deal breaker if you can only take her to retaurants with double doors.

All I meant about the AF was that it seemed like they produced the unhappiest type of Medical Officer. I realize there's a chicken and egg problem there, but none the less it seems like most people on this board (and docs that I've met personally) would recommend the OP narrow his choices to to Army and Navy if he chooses to do milimed at all. Did I misinterpret? Would the AF docs on here, if they had to do milimed again, have chosen AF a second time?

 

[colbgw02]

You also have to know that you may not be able to choose your specialty

The main difference that people forget about all the time, is you already have the residency of YOUR CHOICE (Both specialty and location).

Just wanted to clarify that the military cannot force you to do a specialty not of your choosing. So, strictly speaking, it is inaccurate to say that the military denies you your choice of specialty.

To the OP, what they can, and do, deny you, is the opportunity to complete your residency of choice in a prompt fashion. They can force you to spend some or all of your obligation as a general medical officer.

 

[TheGoose]

The main difference that people forget about all the time, is you already have the residency of YOUR CHOICE (Both specialty and location). Your commitment is nearly identical to the HPSP program.

I'd just like to throw out that my main interest in HPSP vs. FAP is that my AD obligation would be completed earlier in my life. The committment may be nearly identical to the HPSP in years of service but the committment of being stationed and deployed post-residency (and most likely once you have a family) is the reason HPSP trumps FAP for me.

 

[sethco]

Would the AF docs on here, if they had to do milimed again, have chosen AF a second time?

Absolutely.

(Assuming I went the military route, of course)

Didn't mean to accuse you or anything, but you did say "You need to be doing this for more than financial reasons". You did not say solely for the money. Galo said something much closer to that statement than yours (not to mention that he didn't go on to talk about the reasons he went into the military which you referenced money as 2/4 of your contributing factors).

Anyway, it doesn't really matter. It really is hard to get opinions from docs who know the current state of military medicine and are willing to be open about it in public. The fear of reprisal is very significant and keeps current Active Duty docs from being absolutely truthful. Retired docs may not have a better view because military med has changed significantly over the past couple of years. I am not making any blanket statements like all military medicine sucks and is evil, but it really annoys me when medical students that have not even been on a freaking 45 day ADT yet (save for OTS/OBC, let alone started on active duty), are giving all these pros/cons about military medicine. This is basically akin to the blind leading the blind. Unfortunately, there may not be an accurate place to get true opinions regarding the state of the military, so most applicants just listen to what the recruiter says and takes it for face value. The one good thing about this site is it is all anonymous. The downside of that is that it also attracts more people with negative experiences.

 

[sethco]

Just wanted to clarify that the military cannot force you to do a specialty not of your choosing. So, strictly speaking, it is inaccurate to say that the military denies you your choice of specialty.

To the OP, what they can, and do, deny you, is the opportunity to complete your residency of choice in a prompt fashion. They can force you to spend some or all of your obligation as a general medical officer.

Sorry, did not mean to imply that they can FORCE you into a residency that you did not choose, but do you consider Flight Medicine a specialty? Because, they can certainly deny you a residency and FORCE you to be a GMO/FS for a minimum of 2 years.

Speaking of which, one more thing that really pisses me off is when some of the posters (that shall go unnamed) have said that GMOs are GMOs for a reason. Basically implying that they are stupid, inferior candidates that breezed through medical school near the bottom of their class, barely passing their boards, and having really poor patient skills. Politics plays a huge part in the JSGME residency selection process. HPSP students without prior military experience are really playing against a stacked deck (especially when they are going for a competitive specialty). The funny thing is, what is competitive in the military is not necessarily competitive in the civilian world (as least not to the same level). Good examples of these are Emergency Med, Anesthesiology, Ortho and Radiology. Of course competition among residency spots varies on a yearly basis as number of spots and applicants fluctuates, so it is nearly impossible to predict which residencies are going to be harder to get. I guess thats why I am a much bigger advocate of the FAP than the HPSP program

 

[sethco]

I'd just like to throw out that my main interest in HPSP vs. FAP is that my AD obligation would be completed earlier in my life. The committment may be nearly identical to the HPSP in years of service but the committment of being stationed and deployed post-residency (and most likely once you have a family) is the reason HPSP trumps FAP for me.

In that case, let me suggest that you defer residency until you are done your military commitment. Just serve out your ADSC as a GMO or Flight Surgeon. This seems to be the quickest way out of active duty. Just keep in mind that you have to complete a total of 8 years service commitment. What you don't serve as active duty, has to be served on IRR where you could be recalled back into active duty. This could be even worse if you get pulled halfway into your residency and then the program fills your spot. This brings up a huge funding issue with residency programs. This is not very likely, but still possible.

Oh well, that's enough for right now about venting. I will be taking advantage of one of the military perks by catching a space-a travel flight to England and then Germany tomorrow with the wife and kids. Anybody you has the opportunity and is flexible, I would highly recommend trying space-a.

 

[Perrotfish]

Absolutely.

Could you please elaborate?

(not to mention that he didn't go on to talk about the reasons he went into the military which you referenced money as 2/4 of your contributing factors).

Not all bullet points are weighted equally, okay? 2/4 bullet points does not mean that my reasons for going into the military are exactly half financial.

 

[IgD]

Just wanted to clarify that the military cannot force you to do a specialty not of your choosing. So, strictly speaking, it is inaccurate to say that the military denies you your choice of specialty.

The recruiter saying you get your choice of specialty training is like the airlines offering $99 tickets. It's true because they have 1 or 2 at that price. The purpose of the ad is to get people in the door.

 

[TheGoose]

In that case, let me suggest that you defer residency until you are done your military commitment. Just serve out your ADSC as a GMO or Flight Surgeon. This seems to be the quickest way out of active duty. Just keep in mind that you have to complete a total of 8 years service commitment. What you don't serve as active duty, has to be served on IRR where you could be recalled back into active duty. This could be even worse if you get pulled halfway into your residency and then the program fills your spot. This brings up a huge funding issue with residency programs. This is not very likely, but still possible.

Oh well, that's enough for right now about venting. I will be taking advantage of one of the military perks by catching a space-a travel flight to England and then Germany tomorrow with the wife and kids. Anybody you has the opportunity and is flexible, I would highly recommend trying space-a.

my plan is to do gmo then go out to residency =D
(oh and im only planning on a 2yr hpsp)

 

[Perrotfish]

You're aware that the minimum AD commitment is 3 years, right? It's in the service contract and everything.

 

[TheGoose]

You're aware that the minimum AD commitment is 3 years, right? It's in the service contract and everything.

yeah - from what i understand, internship counts towards minimum service obligation (MSO), thus, internship + 2 year GMO =IRR

if im wrong please correct me as that would be an eye-opener

 

[Perrotfish]

I don't have the service agreement in front of me, but I though internship and residency only counted towards your IRR commitment, not your AD commitment. So if you do the internship and 2 years AD for a 3 year commitment you would still owe 1 year AD and 3 years IRR.

Again I'm not sure, but make sure you clarify this before signing anything.

 

[TheGoose]

no doubt that i would clarify this information before doing anything. from my research though - although internship and residency do not count for active duty commitment, internship counts towards the minimum service obligation of 3 years (because you are AD when on internship, just not counting for scholarship payback)....ill research some more and post some facts if i can find it.

 

[TheGoose]

refer to http://forums.studentdoctor.net/sho...t=%2Bminimum++service++obligation++internship

then refer to 2 year hpsp chart and follow the line : "one year military internship/operational no residency....

i believe this outlines that a 2 year AD committment is all that is left after internship...

i dont know what CSAB stands for however (the line right under that one), which said a 3 year committment. If you know what CSAB is that would be good to know

 

[BomberDoc]

Seriously, guys, interest rates are pretty damn low right now and you can get subsidized loans while in med school. This makes medical education as affordable as possible. I personally wouldn't recommend it, but if you want to live large, borrow some extra and enjoy life a bit. You will be able to pay it off and you will be able to do it sooner and easier than going the military route.

I may come off as a blowhard, but if you read some of my other posts, the financial incentive to join the military just isn't there. I have seen firsthand the financial implications. One of my closest friends tossed around the idea of doing HPSP when I was also making that fateful decision so many years ago. He decided against it. He did an Internal Med residency and now practices in a fairly rural setting. He isn't working to death, makes over 250k and is going to finish paying off his unsubsidized loans this year. It only gets better as he will become a partner in the practice next year. The subsidized loans at 3-ish% make no sense to pay any earlier. I am behind each and every one of my peers with respect to salary and experience.

Caveat emptor.

 

[orbitsurgMD]

Hey everybody,

I will be attending medical school this upcoming fall and I have been looking at different routes for paying for this next excursion in my life. I have always wanted to do the military route, but I wanted to ask anybody who was doing it whether or not it was working out for them. If I do it, I will probably go Air Force route. Any input would be greatly appreciated, thanks-

spacemanspiff17

[Bolds mine]


It has been posted on this board, oh, about a couple hundred times already, that the reason to take the HPSP scholarship for medical education (for someone not already in the service) should be because you want first to be in the military and a very distant second, because you want the financial support. Now that might seem to make little sense, since the services themselves sell their scholarships the other way round, but the opinion of the experienced--those who have been there and done that--is that is the best way to consider HPSP.

There are other and better ways to get money for medical school. There are other, better and more secure ways to get residency training in a desirable field, and there are other and better ways to accomplish both and still make an opportunity for yourself to do military medical service (e.g., FAP.) Now that that fact is a little more widely understood, the military services are going begging to fill HPSP slots. As they should.

The medical departments have unfortunately become sort of a liars club. That might be kind of fun as an after-hours diversion, but as a foundation for making important life-altering decisions that will affect how you will be living for a long time to come, you can and should do better for yourself than to make a pact with them so early in your career.

 

[TheGoose]

refer to http://forums.studentdoctor.net/sho...ght=+minimum++service++obligation++internship

then refer to 2 year hpsp chart and follow the line : "one year military internship/operational no residency....

i believe this outlines that a 2 year AD committment is all that is left after internship...

i dont know what CSAB stands for however (the line right under that one), which said a 3 year committment. If you know what CSAB is that would be good to know

can i get any confirmation if my reasoning is correct according to the chart from the link above?
1 yr intern + 2yr operational GMO = payback complete?
(plus all the IRR too)

 

[FL350]

can i get any confirmation if my reasoning is correct according to the chart from the link above?
1 yr intern + 2yr operational GMO = payback complete?
(plus all the IRR too)

No. While you payback time you owe for school while doing a military internship/residency, you accrue a year of AD time for each year during that residency. You will owe a minimum of 3 years of AD time.

 

[Perrotfish]

No. While you payback time you owe for school while doing a military internship/residency, you accrue a year of AD time for each year during that residency. You will owe a minimum of 3 years of AD time.

???. He didn't say he was going to do a residency, and Internship year is Neutral anyway (that's why you can finish an Ortho residency straight through and still only owe 4 years of AD) If he's allowed to commit to 2 years of AD his math is correct.

That being said the service agreement I'm looking at seems pretty clear that the minimum AD commitment is 3 years, and the minimum total commitment is 8 years. Therefore after an Internship (which count for any time served, even IRR time) it seems like you would still owe 3 years of AD and 5 years of IRR. Goose do you have a copy of the service contract they want you to sign? You need to read over it very carefully.

 

[TheGoose]

i appreciate your response. This information wouldnt really sway me away from doing the program but im confused by the chart below. note the line i have highlighted which states that payback would be 1 yr internship, and then 2 yrs after internship (specifically stated). Unless i am reading this chart inherently wrong, it seems like it is suggesting only 2 yrs post-internship AD coimmittment. Responses please?

perhaps they add on the extra year once you do internship like you said but that would make this chart practically a trick to recruits. thoughts?

EDIT: it appears that the 3 year obligation is for individuals who take a civilian internship deferment rather than those who take a navy internship. just saw that and figured i'd throw it out there

 

[TheGoose]

dont have a copy in front of me but im trying to get my facts straight - thanks perrotfish....i agree that 3 yr active duty is right but i know in the back of my head that i heard somewhere that internshi[ can offset one of those yrs from that 3yr period. I think it would be weird to have the chart above as an official payback chart but then say "oh yeah, you owe one year extra too" but hey, thats the us govt....we shall see