More second-hand info about army deferrments

[Neuronix]

Here's some info I picked up from my friends who have been speaking with the GME coordinator since they've been here in Philadelphia.

This past year everyone matched into the specialties they wanted, with one glaring exception. This means that everyone either matched in the Army or was granted a civilian deferrment if all the Army spots were taken in their chosen specialty. Further, those who really wanted a deferrment even if they matched in the military were "usually" given permission to match in the civilian world. The exception is PM&R. The Army does not have enough jobs for the number of people who applied for PM&R last year, and I don't know if any of those who didn't match in the military will be granted civilian deferrments to persue PM&R. Their options are to take a different residency from what's available PGY-2 or GMO.

To add flames to the fire from an old thread, yes, the short OBC for medical officers was very ramped up last summer. Apparently some higher-ups felt it was "too easy" in past years. This led to a higher number of drop-outs, but in reality this was a high proportion of those who started OBC before they started collecting the HPSP scholarship. Anyone who was already collecting Army money in med school was not allowed to leave, as they were in previous years.

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[qqq]

Anyone who was already collecting Army money in med school was not allowed to leave, as they were in previous years.

This is so ridiculous. Another thing that is ridiculous is the AF HPSP pamphlet. I got one in the mail yesterday and it is just a bunch of lies. The military would serve themselves so much better if they were just honest for once. They would actually get the people that want to be in the military.

 

[Croooz]

This is so ridiculous. Another thing that is ridiculous is the AF HPSP pamphlet. I got one in the mail yesterday and it is just a bunch of lies. The military would serve themselves so much better if they were just honest for once. They would actually get the people that want to be in the military.

Why is this ridiculous?

 

[qqq]

Why is this ridiculous?

Maybe I'm taking it the wrong way, but by OBC I think of Basic Training. At the Academy, people can leave during basic training if they don't like it. This system means that people that got through basic training and liked it will stay, while those that had a hard time or decided that this first glimpse of the mlitary is simply not for them can leave. It breeds a better and more cohesive team because you've weeded out the people that simply don't like the military (and as we know, basic training can be a real "welcome to the realities of the military" experience.) I think the same should exist for the HPSP program. I think hpspers should still have the option of leaving if they find out that during basic training the military isn't for them. It's no wonder so many docs get out of the military when the standard HPSP applicant that never came to this site is misled by recruiters and pamphlets that essentially say "come get this free money!" or "look, real short and easy basic training - in fact we'll give it another name and we won't even call it basic training." If the mlitary wants officer physicians, then they should promote that from the start - right from the very beginning of the recruiting process. Instead, they lure people in with money. and they do it shamelessly.

 

[delicatefade]

I have a really hard time believing that OBC is THAT hard....but then again I've been to USAFA. I agree that people should be able to leave during OBC if they find out it isn't for them. Everyone at any of the military academies is free to leave anytime until the first day of classes junior year with no obligation other than maybe a few miscellaneous expenses for computer and uniforms.

 

[Croooz]

Wait a second now...We're not talking about high school kids here. We're talking about 22 year olds who graduated college so should have some idea of critical thinking and just plain old common sense. If they've already signed the dotted line it shouldn't matter 1 hill of beans whether they like OBC or not. They're adults and signed a contract.

If the military would require a HPSP to go thru OBC first, to get an idea what it is they would be getting into and only after graduation would they be allowed to receive the stipend and such then I would agree with you. As it stands now sure the military isn't putting all it's cards on the table but who's signing the contract? There's all kinds of info out there now so there's no excuse for not knowing what you're about to sign nor the conditions.

 

[delicatefade]

I should have qualified that. I think OBC should optimally be in the summer before your first year of medical school. Then if you don't want to do it, don't take the scholarship.

 

[Neuronix]

They're adults and signed a contract.

The same stands for MD/PhD students, but we are in no way locked into the program. If we decide research isn't really right for us, we can go to the MD or PhD-only programs at any time without payback or retribution. In my mind, it implies that they're really trying to make this a good experience for us as MD/PhD students. What incentive does the military have to make the military a good experience for you? One could argue they can't and shouldn't have to, but at the same time, what about that post in another thread about the difficulties of recruiting well-credentialed physicians (http://www.usmedicine.com/column.cfm?columnID=147&issueID=56)? So, the military has two ways it can go to try to recruit...
1) Ramp up recruiting of pre-meds, fix nothing, and continue the assembly line approach with very low retention of physicians
2) Try to make the system more supportive of families and personal goals
Which one will it choose?

I understand your point Crooz, I'm just arguing that it doesn't have to be that way. I would further argue that the reasons for the lock-in are dubious--we need physicians and we don't care whether or not you like it when you find out what things are all about or if your life changes. No US civilian court would uphold a contract that forces you to sign away years of your life years before you're actually doing them. In fact, there used to be a MD/PhD payback clause at the MSTP schools and that was successfully challenged in court and struck down (i.e. the student did NOT have to pay back and could NOT be held to the contract). The only way the military gets away with what they're doing is with the military courts. Believe me, ask even innocently about leaving and the response will be "court martial" "court martial" and "court martial". At least with SDN nobody can complain they didn't have the straight scoop anymore. Again, before this forum was created, there was no objective source for military medical information.

 

[Croooz]

What is the school losing if you decided that research wasn't for you? I'm not sure how it works but did you have to sign a contract?

We're talking about the military paying for years of school and years of a stipend for the student to say "I don't want to play anymore"? I know many students who did their OBC the summer they graduated from medical school. I just can't see this being how business arrangements should be conducted. I know the military paints a very rosy picture but it's up to each of you to do your research and see if what you're hearing is true...even or especially from this forum.

There's no debate that military medicine is lacking but as long as there's a constant influx of new HPSP's the military won't change. Once people start getting over their fear of good debt and realizing that us military naysayers have nothing to gain from just telling you our side perhaps this will affect the numbers entering causing change. As you can see from the article many "senior" physicians are against getting rid of GMO tours. I'm of the opinion that is the good ole "if I had to do it, so will you..." mentality.

 

[Mirror Form]

I have a really hard time believing that OBC is THAT hard

Seriously! After having done ROTC in undergrad, I want to punch every single person who complains about how hard OBC is now. It's still an F'ing joke compared to what most officers go through.

 

[Mirror Form]

Maybe I'm taking it the wrong way, but by OBC I think of Basic Training. At the Academy, people can leave during basic training if they don't like it. This system means that people that got through basic training and liked it will stay, while those that had a hard time or decided that this first glimpse of the mlitary is simply not for them can leave.

I completely disagree on this matter. OBC is not designed to be anything like basic training. It's for people who are already officers. Basic Training is for raw recruits. Besides, most cadets in the army are allowed to quit within their first year; but by the time they reach advanced camp (not the same thing as OBC, but in this case it's a little bit analgous), it's too late to forfeit their scholarships . . . the military has put too much time and money into you by that point. And for the most part, OBC is nothing what life as a military doctor is like. Therefore, quitting b/c you don't like it doesn't make sense anyway.

Doctors have to go to OBC so that you'll have some grasp of what the normal military is like. It's kind of like having to do surgery rotations during medical school, even though you want to do family practice.

 

[Mirror Form]

Here's some info I picked up from my friends who have been speaking with the GME coordinator since they've been here in Philadelphia.

This past year everyone matched into the specialties they wanted, with one glaring exception. This means that everyone either matched in the Army or was granted a civilian deferrment if all the Army spots were taken in their chosen specialty. Further, those who really wanted a deferrment even if they matched in the military were "usually" given permission to match in the civilian world. The exception is PM&R. The Army does not have enough jobs for the number of people who applied for PM&R last year, and I don't know if any of those who didn't match in the military will be granted civilian deferrments to persue PM&R. Their options are to take a different residency from what's available PGY-2 or GMO.

There's no question that the people applying for PMR got screwed. However, I would bet that overall, people in the army did a lot better at matching then their civilian counterparts (in terms of getting into their desired specialty).

 

[cdreed]

I have to disagree. I attended AF enlisted Basic Training, and it's completely different from COT. COT was a lot like daycare, which really struck me as odd since we're all professionals (lawyers, docs, med students, chaplains and bioenvironmental engineers). I believe that COT attendees were babied to the point that they really don't have a clue what the real military is like sometimes, and they expect the same kid-glove treatment to continue into their careers. I feel that this ultimately leads to dissatisfaction with the system due to inaccurate expectations once on active duty during payback. Hence all the complaining and mass exodus of most HPSP students after their service is complete. COT is definitely NOT as intense as BMT or Basic Officer Traininig.

Perhaps this explains why the AF medical corps personnel have such a questionable reputation. By the time line officers reach O-3, they know and live the military. But new docs begin their service as an O-3 usually with very little understanding of the inner workings of the system. And I fear that this uneven standard is not adequately addressed in COT or beyond.

In addition, I also believe that by the time someome is in their twenties/thirties that he/she should be held accountable for their actions... meaning if they sign a contract then they should be responsible enough and have enough integrity to follow it through. I mean, the 18 year olds that enlist aren't given the option to quit if they suddenly realize that they don't like the military during Basic Training. Should any less be expected of the officers who are supposed to lead them?

Maybe I'm taking it the wrong way, but by OBC I think of Basic Training. At the Academy, people can leave during basic training if they don't like it. This system means that people that got through basic training and liked it will stay, while those that had a hard time or decided that this first glimpse of the mlitary is simply not for them can leave. It breeds a better and more cohesive team because you've weeded out the people that simply don't like the military (and as we know, basic training can be a real "welcome to the realities of the military" experience.) I think the same should exist for the HPSP program. I think hpspers should still have the option of leaving if they find out that during basic training the military isn't for them. It's no wonder so many docs get out of the military when the standard HPSP applicant that never came to this site is misled by recruiters and pamphlets that essentially say "come get this free money!" or "look, real short and easy basic training - in fact we'll give it another name and we won't even call it basic training." If the mlitary wants officer physicians, then they should promote that from the start - right from the very beginning of the recruiting process. Instead, they lure people in with money. and they do it shamelessly.

 

[qqq]

I have to disagree. I attended AF enlisted Basic Training, and it's completely different from COT. COT was a lot like daycare, which really struck me as odd since we're all professionals (lawyers, docs, med students, chaplains and bioenvironmental engineers). I believe that COT attendees were babied to the point that they really don't have a clue what the real military is like sometimes, and they expect the same kid-glove treatment to continue into their careers. I feel that this ultimately leads to dissatisfaction with the system due to inaccurate expectations once on active duty during payback. Hence all the complaining and mass exodus of most HPSP students after their service is complete. COT is definitely NOT as intense as BMT or Basic Officer Traininig.

Perhaps this explains why the AF medical corps personnel have such a questionable reputation. By the time line officers reach O-3, they know and live the military. But new docs begin their service as an O-3 usually with very little understanding of the inner workings of the system. And I fear that this uneven standard is not adequately addressed in COT or beyond.

In addition, I also believe that by the time someome is in their twenties/thirties that he/she should be held accountable for their actions... meaning if they sign a contract then they should be responsible enough and have enough integrity to follow it through. I mean, the 18 year olds that enlist aren't given the option to quit if they suddenly realize that they don't like the military during Basic Training. Should any less be expected of the officers who are supposed to lead them?

I dont think integrity is really an issue here. Nobody's shirking their commitment. anyway, back to the point--I agree that the 'mass exodus' is partly attritbutable to the fact that folks may be shocked to see that the military is much more than they were exposed to in COT. You're right, as adults everyone has to take the initiative to know what they're getting into. Some people, for some reason, just don't do that. So, in effect, they're signing into a contract without knowing what the stipulations are. That's not necessarily the recruiter's fault, i guess. That's life. EVerybody has to watch their own back first and foremost. unfortunately, it doesn't just hurt the applicant. like neuronix said, it hurts the military. it doesn't breed the best culture to work in. maybe it would help if hpspers went through a real basic before their first year on the scholarship. or maybe if during the summer after msII the hpspers deployed or something. and then if they didn't like it they could get out of the commitment and pay the gov't back for any money they received. yea yea, i know. why don't we all hold hands and stuff. but really, a more flexible contract imho could only help the military medical culture (and retention).

neuronix . . . you're all over sdn? as an mstper y do you take such interest in the military?

 

[Croooz]

I don't think making the contract easier to get out of is the answer. Presenting the difficulties up front, like I said before, to get the HPSP students into the military culture upfront...and regular officer training. Why have the "seperate but equal" bootcamp? It starts the mentality from the start that physicians are special from some reason...yet once the uniform comes on they're explained how they're officer's first??? Then have everyone go to the same "bootcamp" and before you give anyone money let them prove they want it by graduating bootcamp.

This would no doubt drop HPSP numbers but the people you are getting would have a better idea what it's all about. They "paid" the same price as any other officer but here's to wishful thinking...

 

[Neuronix]

neuronix . . . you're all over sdn? as an mstper y do you take such interest in the military?

Because my fiancee is in HPSP and she feels lied to and betrayed. She signed of course before this forum was created, and there was no way for her to get objective information. Obviously, there's no way out for her now, and she doesn't post on SDN because all she gets even when she simply asks a question is "YOU SIGNED, DEAL WITH IT." Quite honestly, when I started here there wasn't alot of info about MD/PhD programs, but that's changed alot. There's still alot of misconceptions and question marks about HPSP, so I'd like to help when I see a need for it. Obviously, I'm not really qualified to comment, but, who is? I'm just passing info from the people I know who are in HPSP and the conversations we've had with higher-ups, which is better than nothing.

To add fuel to the fire--my fiancee feels that if the military let people out of their contracts "everyone would have left after OBC". She feels that about 70% of the HPSP people she met at OBC were just debt-phobic and had no idea what they were getting into. Again, the military is using dubious recruiting to sucker people into HPSP with no regards to how happy or successful they will be in the military.

What is the school losing if you decided that research wasn't for you? I'm not sure how it works but did you have to sign a contract?

We're talking about the military paying for years of school and years of a stipend for the student to say "I don't want to play anymore"?

What does the school lose if you leave MD/PhD (i.e. decide research isn't for you)? All the years of medical school tuition and stipend they paid for (at Penn that would be about $62k/yr since we make $25k/yr stipend). If you leave after your second year, that means the school eats two years of tuition and stipend and you just have to pay for the rest of medical school. Students used to have to sign a contract, but since the contracts were unenforceable in a civilian court, we don't sign anything anymore.

 

[kingcer0x]

I have to disagree. I attended AF enlisted Basic Training, and it's completely different from COT. COT was a lot like daycare, which really struck me as odd since we're all professionals (lawyers, docs, med students, chaplains and bioenvironmental engineers). I believe that COT attendees were babied to the point that they really don't have a clue what the real military is like sometimes, and they expect the same kid-glove treatment to continue into their careers. I feel that this ultimately leads to dissatisfaction with the system due to inaccurate expectations once on active duty during payback. Hence all the complaining and mass exodus of most HPSP students after their service is complete. COT is definitely NOT as intense as BMT or Basic Officer Traininig.

Perhaps this explains why the AF medical corps personnel have such a questionable reputation. By the time line officers reach O-3, they know and live the military. But new docs begin their service as an O-3 usually with very little understanding of the inner workings of the system. And I fear that this uneven standard is not adequately addressed in COT or beyond.

In addition, I also believe that by the time someome is in their twenties/thirties that he/she should be held accountable for their actions... meaning if they sign a contract then they should be responsible enough and have enough integrity to follow it through. I mean, the 18 year olds that enlist aren't given the option to quit if they suddenly realize that they don't like the military during Basic Training. Should any less be expected of the officers who are supposed to lead them?

There is an intitiative at COT to make COT more like BOT... there were meetings about this last summer. In fact, what used to happen was, that HPSP and Medical Corps recruits would just go to the first 3 weeks of BOT. Thus, they would get their uniforms and learn how to wear them, how to salute, but thats about it. COT was meant to integrate 2 years worth of ROTC academic training into 4.5 - 5 weeks, with a scaled down version of field training. I don't feel like I was ever babies because I didnt take advantage of the situation. I allowed myself to be trained by the FTOs with no mention of my status or complaining that I am a medical student blah blah blah. Granted, i got yelled at alot and made stupid mistakes but enjoyed the training aspect of it. This is the version I went to last summer, and at very least, I will know enough to succeed as an officer/physician when i go on active duty. For what I dont know, I will know where to go to look for it. So... as long as you remain motivated to perform your particular job in the military, I dont think this will offend any line officers who assume you dont know what you're doing as an officer. Granted, COT wasn't that hard, but it wasn't easy, and last summer maybe 5% of the class didnt finish. They told one physician that she couldnt continue onto her duty station because she was failing COT.

Also, the AF now has mandatory SAM intro classes for HPSP and USUHS this summer as the 2nd ADT. Yes, mandatory. Its about 3 weeks long. SO, i know full well the AF jokes will continue, but do realize that alot of us HPSP students are committed to becoming useful officers and competent physicians in our military career, some for longer than others. We definitely are not in it for the money.

That being said... the AF is cutting down the size of COT this summer. Really kills my argument... dontknow why they had to do that, i thought it should have been longer. Oh well. Off i go into the wild blue yonder.......

 

[cdreed]

There is an intitiative at COT to make COT more like BOT... there were meetings about this last summer. In fact, what used to happen was, that HPSP and Medical Corps recruits would just go to the first 3 weeks of BOT. Thus, they would get their uniforms and learn how to wear them, how to salute, but thats about it. COT was meant to integrate 2 years worth of ROTC academic training into 4.5 - 5 weeks, with a scaled down version of field training. I don't feel like I was ever babies because I didnt take advantage of the situation. I allowed myself to be trained by the FTOs with no mention of my status or complaining that I am a medical student blah blah blah. Granted, i got yelled at alot and made stupid mistakes but enjoyed the training aspect of it. This is the version I went to last summer, and at very least, I will know enough to succeed as an officer/physician when i go on active duty. For what I dont know, I will know where to go to look for it. So... as long as you remain motivated to perform your particular job in the military, I dont think this will offend any line officers who assume you dont know what you're doing as an officer. Granted, COT wasn't that hard, but it wasn't easy, and last summer maybe 5% of the class didnt finish. They told one physician that she couldnt continue onto her duty station because she was failing COT.

Also, the AF now has mandatory SAM intro classes for HPSP and USUHS this summer as the 2nd ADT. Yes, mandatory. Its about 3 weeks long. SO, i know full well the AF jokes will continue, but do realize that alot of us HPSP students are committed to becoming useful officers and competent physicians in our military career, some for longer than others. We definitely are not in it for the money.

That being said... the AF is cutting down the size of COT this summer. Really kills my argument... dontknow why they had to do that, i thought it should have been longer. Oh well. Off i go into the wild blue yonder.......

I was at COT last summer. It wasn't that difficult. And I am what some might consider old. What they teach at COT is not in and of itself enough to succeed, but it's a good starting point. And I wasn't suggesting that line officers would be offended. I meant to imply that many of the enlisted personnel in your charge may be somewhat disappointed. How can an officer truly lead them without understanding their perspective and what they've been through... at least a little? I speak from personal experience as an enlisted troop under the command of sometimes ineffective physician leaders and as a soon to be AF doc.

 

[Croooz]

What does the school lose if you leave MD/PhD (i.e. decide research isn't for you)? All the years of medical school tuition and stipend they paid for (at Penn that would be about $62k/yr since we make $25k/yr stipend). If you leave after your second year, that means the school eats two years of tuition and stipend and you just have to pay for the rest of medical school. Students used to have to sign a contract, but since the contracts were unenforceable in a civilian court, we don't sign anything anymore.

The school eats that money...if HPSP does it who eats the money? There are people exploiting the PHS getting med school paid for and not ever paying back their time...who loses out...the underrepresented. If HPSP would allow those who didn't want to after they paid money what situation would the military be in? I'm not all for the way it's done now but allowing those who simply "realize they made a mistake" out of their commitment is not how the grownup world works. Not insinuating you don't know this but if these students would research they would save themselves a decade of heartache.

I'd venture a guess and say the decrease in HPSP and USUHS are the thousands of lurkers who are spreading the other side of the story which they are getting from here. When I went to FIU to ask about pre-med I was directed to this site. FAU, U of Miami, Barry, and St Thomas did the same...I would guess it's the same throughout the nation. I'm hoping things start to turn around and we begin to get a fleet of physicians who made a decision based on the facts and their debts....

 

[Neuronix]

The school eats that money...if HPSP does it who eats the money?

A substantial percentage of the money is coming from the NIGMS budget.

There are people exploiting the PHS getting med school paid for and not ever paying back their time...who loses out...the underrepresented. If HPSP would allow those who didn't want to after they paid money what situation would the military be in?

I agree. There should be a payback clause.

 

[RichL025]

There is.

I was the class leader for the 300+ people at the Army OBC "short course" 2 1/2 years ago.

The majority of students were, of course, HPSP (I'm USUHS) and attending after having already gotten the scholarship for a year.

The overwhelming majority of the HPSP people were motivated, great people who were completely new to the military, but wanted to learn, and do a good job. There were, of course, one or two "problem children".

One of them did so poorly (because of attitude) that he was, in effect, offered the chance to quit the scholarhsip and enter into an agreement to repay the one year of support he received. As far as I know, it was a legally-binding contrcat that he will hopefully adhere to (I'm guessing they allowed for deferments to await paying it back until he's out of training).

Everyone benefits - the Army because they don't have a bad-attitude MD, and the individual in question, because he got to rectify his glaring error.

But, I have to tell you, the vast majority of HPSP people I met were motivated, great individuals who were genuinely interested in serving their country. Debt avoidance was certianly one of their reasons, but not th eonly one, not even the major one.

 

[Neuronix]

There is.

No, there used to be. My point was that the Army isn't letting anyone out NOW. At last summer's OBC there were alot more drop-outs than just one, but these were people who hadn't already been receiving the scholarship. Everyone else was stuck.

 

[RichL025]

No, there used to be. My point was that the Army isn't letting anyone out NOW. At last summer's OBC there were alot more drop-outs than just one, but these were people who hadn't already been receiving the scholarship. Everyone else was stuck.

Ah, well. <hollow laughter>

Just like the old days, I guess, where people didn't figure out what the army was really like until after they were stuck in it

Good thing is, there's plenty of jobs where the person is barely in the "real army" at all... unless they go primary care and wind up as a Bn Surgeon somewhere...