National Health Service Corps

We have a forum for these issues. Will move to that forum for comment.

 

- I am currently in the program.

- The NHSC is actually a part of the Public Health Service, but it is best known for its scholarship and loan repayment programs.

- The scholarship process just changed this year. Two years ago, they stopped requiring interviews. This year, they changed the process from a multiple-choice questionaire to 5 essay questions.

- The scholarship is fairly competitive, although no one is completely clear on how they decide who to give the scholarship to. Back when it was a questionaire, there were rumors that your answers gave you a certain "score," but that's all moot now.

- A fair number of people do this program, although probably more than we see in PA. It's probably more popular in certain areas of the country - i.e. regions that are fairly rural and qualify as medically underserved.

- The scholarship pays for all of your tuition and a lot of your expenses. You pay them back with one year of service for one year of scholarship, with a minimum payback requirement of 2 years.

- The difficulty with the scholarship is that it locks you in to certain medical specialties: Internal Medicine, Family Med, Peds, Psych, or OB/gyn. If you realize during your 3rd year that you love emergency medicine, too bad. If you realize that you absolutely LOVE orthopedics or anesthesiology, you're out of luck. You MUST practice one of those five specialties (although exceptions would probably be made for some combos - for instance, Med-Peds, or Pediatric Psych, etc.)

[NOTE: You MUST pay back your service requirement as soon as you leave residency. You do not have the option of doing a fellowship first, except for a few very specific instances (ex: You can do an OB fellowship or a geriatrics fellowship after a family med residency, but you canNOT do a sports medicine fellowship after a family med residency. And you can't do a GI or a cardiology fellowship after IM, at least not until you've finished your service payback.)

- You can do residency wherever you want. But you must practice in a federally designated underserved area. They decide which areas you can serve in based on a federally designated HPSA score, which has to be more than 14.

- IF you are pro-active and really on the ball about finding a job, you can go wherever in the country you want. If you proscratinate, though, the government will randomly place you wherever they need you.

- IF you skip out on your scholarship, or you realize at some point that primary care is not for you, you will owe the government THREE TIMES as much as they paid.

 

Awesome post! This is very helpful. I want to do infectious disease but work in underserved areas as a primary care physician for a long term career. Do you know if an ID fellowship would be acceptable after residency in internal medicine?

 

No, it's not.

I don't think that ANY fellowships after an IM residency are acceptable, with the possible exception of women's health. Like I said, they are very strict about what fellowships you can do.

 

Well that's extra stinky! You'd think an ID fellowship would be very helpful... Oh well.

 

I strongly advise against signing a contract that obligates you to the federal government. There are many opportunities for physicians to contract in a given county, group or hospital that will provide financial assistance with student loans. I am currently employed at a public health center repaying a "scholarship" from the National Health Service Corps and while I enjoy working with medicaid and uninsured patients, the frustration of dealing with inept management, hideous medical recordkeeping and incompetent (or completely lacking) support staff makes me want to poke my eye out. I am an OB/Gyn and was unable to stay in the southern united states as it is very difficult for the sites to qualify. The requirements are based on the total number of physicians, not the type of MD. So while there were many places desperate for an OB doc, there were too many generalists for them to qualify. Now I live 500 miles from my family and am practicing in an urban underserved area instead of a rural area. NHSC will severely limit your choices both of residency and area of practice. By the way, I was offered complete loan repayment, sign-on bonuses and excellent salary from several practices in rural underserved areas. I also began practice search over a year in advance and was actually told by NHSC that it was too early to begin searching for a job when I asked for assistance. DON'T DO IT!!!

 

Am a long time lurker to SDN and forget my original login. I want to echo the statements Perle made above.

I'm a NHSC scholar (family physician) with about 18 months left of a four year commitment. Work in a community health clinic. DAILY I deal with: medicaid/uninsured patients (LOTS and LOTS of medicaid), limited clinical staff, and insanely incompetent administration. Fortunately, I'm in an area close to family and (generally) acceptable for my wife. However, at the beginning of my commitment, I was in another facility (another state) and quit after 18 months (vindictive administration, blatant incompetence, shoddy records, on and on) - the transfer process (to my present clinic) took THREE MONTHS with the NHSC.

My recommendation: DO NOT sign with the NHSC - they are a bureaucratic nightmare and their "Opportunities List" is limited at best (especially in several specialties, family medicine is generally OK). If you are one of the unlucky [email protected] that has signed: start early, search extensively, and evaluate thoroughly for an adequate job.

Hospitals/local county clinics/etc will help with your medical school loans (plus they may offer a sign-on bonus). The pay and environment will be MUCH BETTER. I feel like I have aged 10 years while working with the NHSC and their "clinic sites".

Now, there are a SOME positives (of being a NHSC scholar and working with the underserved): I know the Wal-mart/Target $4 drug list by heart and can get a patient the cheapest meds, I know the intricacies of every patient assistance program in the area (for rx drugs, specialists referrals, outpatient procedures, etc), have learned a great deal (have managed some diseases that most family physicians would not), and the patients (generally) are appreciative.

PM/DM for more specific info or questions. I will be happy to post any GENERAL questions on this forum.

 

This is an incredibly helpful comment. Thank you for posting it!

How many years do you owe, in other words, for how many years did you have the scholarship? Would you reccomend the scholarship with more/less time committed? I know, for example, most people say it's not worth it to join the military unless you do it for all 4 years, because they also restrict one's residency choices. Do you have similar feelings?

I did not know that the NHSC is managed poorly. That is awful. That will play in my decision to apply. Why did your chagne of post take 3 months? What was the excuse?

I do understand that working for the NHSC is highly stressful in that you have a predominantly poor population who uses Medicaid and other state programs. I know the pay is not great, and that there are no sign-on bonuses. I may be completely naive when I say this, but: I don't much care about those issues. It seems like (at least from their website! )that one can really make a difference, and that's what I'm after. The combination of being able to work for a population who really needs it, and the added benefit of not having to worry about debt during/after medical school, seems like a very alluring combo. Can you tell us your reasoning for joining the program? Keep in mind that medical school has increased in price, even since you graduated which was not that long ago. My COA (cost of attendance) is $59,000 at PCOM, and my partner who is at a state MD school pays $50,000. With these figures in mind, does your opinion change?

You did mention at the end of your post that most people appreciate you. And the hospitals/clinics that the NHSC places you at really need help, right? Insofar as you are helping the underserved, do you feel like the experience is rewarding?

Thanks in advance.

 

To answer the above questions:

- I have a four year commitment
- I would absolutely recommend the scholarship with a less time commitment (3 years would be ideal)
- I wanted to do some sort of primary care prior to entering medical school
- The NHSC (division of HRSA) is typical of any US gov't entity (not that it is managed "poorly") - bureaucracy upon bureaucracy upon bureaucracy
- My "site transfer" took 3 months - and it was EXPEDITED - one needs extreme patience with the NHSC

Now, I was extremely naive in my early medical school years as to what my specific job prospects would be - yeah, I genuinely wanted to help the poor and indigent - but, I just had no idea at what REALLY existed in these community health clinics - I have personally witnessed malicious administrations, poor/inferior record keeping, stretched and unappreciated clinical staff, medicaid paperwork that would make your eyeballs explode, etc etc. No wonder there is high provider turnover in these facilities. Who wants to deal with this? If I could kick out the clinic administrations/boards, eliminate the crushing HRSA regulations, and terminate all managed care medicaid, I would be a much happier provider (more "control") and JUST HELP THOSE WHO NEED IT.

After finishing my commitment, I feel I will have "earned" my scholarship. Currently, I'm "cruising" - crazy, but I'm almost enjoying my time now...

 

Thanks for your advice drfranklin. Per your suggestion, I will wait a year and reevaluate.

Take care, and good luck finishing the rest of your commitment!

 

I missed the bus on the NHSC scholarship (although it appears that was a good thing) but I am now entering residency and planning on going into primary care (Med-Peds) and am interested in the loan repayment program. Is there anyone out there that can give a nice summary of how the loan repayment program works and what type of timeline one should be thinking about if they want to enter into it? Thanks!!

 

Since you're now going to enter residency, there's not much to do for now. You don't apply for the Loan Repayment Program until your final year of residency.

Like the NHSC, you must serve as an attending in an underserved area (with a federally designated HPSA score below a certain cut-off) for at least 2 years. If you do that, the NHSC will give you $50,000 towards repayment of your school loans. You can choose to apply for 2 more years of participation in the program, although I'm not sure how much they pay you on your 2nd round of service.

Their website may help. Good luck!

 

Any depth to this statement? Is it on their website? I am wanting to do sports medicine, but also want to apply for the NHSC. Will I have to wait 'til after my service if accepted?

 

that statement is 100% correct. You can check the website if you need "proof" Sports medicine is not primary care, so they are not going to wait around for you to learn it before repaying your commitment. You can do IM, PEDS, PSYCH or FP (with either an OB/women's health, or Geriatrics fellowship) and that is it! If you want to ultimately be a cardiologist, or peds nephrologists, or sports med doc, you will have to complete your gen residency (3-4 years) then serve the NHSC up to four years depending on the length of your scholarship, and THEN you could go back and apply for fellowship.

 

As cali-OB stated, their website, and the scholarship bulletin, clearly define what is "eligible" and what is not:

http://nhsc.bhpr.hrsa.gov/applications/scholarship/1.htm#deferments



So, sadly, no, a sports medicine fellowship is not allowed while you still have a service payback.

 

Muchas Gracias Amigos/as. I think that's better anyways to do four years of work and get plenty of experience, and also gives you time if you still want to add a fellowship on the end.

 

Here is a conversation between Dr Franklin and I. He has agreed to let me post this as I think many of you will find it insightful...

ME: Thank you so much for your honest answers. I am a 4th year med student and NHSC scholar. I was just curious what kind of paycheck do you get and when you say start a relationship with a clinic early, how early? Like now during med school or in residency? How should I go about doing it? Have you heard if you can get a clinic that is an area you like to fill out the paperwork and become a federally qualified clinc? THanks for your time.

DRFRANKLIN: Salaries will vary geographically across the US with the South (believe it or not) having the highest salaries for primary care (due to lack of significant HMO penetration). Fortunately, I live in the South (SC). Starting salaries here for a FP in a community health clinic (CHC) start [higher than average] (outpatient only). If you happen to perform lots of procedures and/or do inpatient work, your salary may be higher. The salaries at CHC's are *somewhat* negotiable - but available money at a CHC is VERY LIMITED. Unfortunately, you will make nowhere near what a private attending could make - salaries with a year or 2 of experience in FP can make [more] (outpatient only).

You *can* find positions outside the NHSC opportunities list. In fact, I *created* a position in NC - but the paperwork with the NHSC took 3 months; and, ultimately, this position did not work out. But IT IS POSSIBLE.

For clinic openings, look at the NHSC "jobs opportunities" website. I'm not sure what specialty you're going into, but FP has the greatest number of positions.

Start early (end of 2nd year of *residency* for FP, don't waste your time now as a med student) and search carefully for a position. When interviewing: talk to the clinical staff, talk to the docs, talk to the docs that have left/quit. Ask as many questions as you can. Finally, pick an area of the country you will BE HAPPY IN (and close to family, if that's important to you).

Now, just relax, finish med school, and focus on doing well in residency. Again, don't start "job seeking" until the 2nd year of residency (if you have 3 years). I interviewed for a position in middle of my second year of residency - people thought I was crazy - but, with the NHSC, it's really NEVER TOO EARLY.

 

I signed up for the Student Doctor Network for the sole purpose of trying to get the word out about the National Health Service Corps. I have not have a good experience with this so-called "scholarship." Like most of you, I was 21 and finishing up college when I applied for the scholarship thinking that it would be a great deal, and I thought I wanted to do primary care or Ob/Gyn at the time. My parents could not help me pay for medical school, and I was facing $30,000 a year in tuition at a private medical school. Very soon after I signed on for the scholarship, I regretted my decision.

You may think you want to do primary care now, but PLEASE consider the fact that most people change their minds when they get to medical school. If you limit yourself by taking the scholarship, you will miss out on a ton of possibilities and may be extremely unhappy with primary care. You may get to medical school and love a subspecialty like radiology or optho that you had no experience with or had never considered before. I am now an Ob/Gyn, but I couldn't even consider a ton of other specialties that I really liked because I was limited by the NHSC. When I tried to get out of the deal, they said it would be three times the loan amount plus interest to pay it back (adding up to over $300,000 for what was a $60,000 scholarship), and even though I contacted them in my first year of medical school, they required that I do at least 2 years of service.

That was only the beginning of the nightmare. When it came time to try to find a position in my last year of residency, I discovered that the NHSC is not helpful at all with the job search. They make a big show of it and have you go to a coference and meet with an "advisor" who basically doesn't help you at all. They score different jobs or cities with HPSA scores, and as an MD, that score had to be a 14 for me to work there. My husband was living in Columbus, Ohio, and I was finishing residency in Alabama, and the score in the area where he was living was 13, and the NHSC does not work with you, so I basically have been living apart from my husband for the last 2 years because the HPSA score in his area was one point lower than the NHSC would accept.

On top of that, the jobs for Ob/Gyn were few and far between. The two jobs I looked at were ones that I found myself, and the center where I work in Mississippi had to create a position for me, as did the center I was looking at in Cincinnati. I worked for 6 months on creating an NHSC job in Cincinnati only to have it fall through. It is only because of a friend who worked in Mississippi that I was able to create another job. The other possibilities on the NHSC website basically boiled down to San Jose prison. Also, for Ob/Gyn, the sites are mostly clinics, and they do not help you with hospital privileges or arranging anything you'll need to do deliveries or surgeries. I had to join a practice part-time to get all of that straigtened out, so to meet the 21 hours of underserved clinic time required for Ob/Gyns, I work in the community health center two days a week, which consists of two 10.5 hour days, and I miss out on delivering or taking care of my patients at the hospital and at my other office.

I won't even go into the frustrations of working in a community health center, but I have not been happy with my job, and all of this has put a strain on my personal life. Because I had to join a private practice so that I could have a normal Ob/Gyn job (i.e. with surgeries and deliveries and not just clinic hours), I am going to owe a $60,000 malpractice tail when I leave so that I can finally move and be with my husband who has been unable to move because he was already commited to a training program before I started searching for my NHSC job. Basically, I am going to owe a tail that is equal to the amount that the NHSC paid me, so I could have just paid that toward my student loans myself. Also, keep in mind that, when you start working, if you have a good job, the hospital usually pays towards your loans, and you will make enough to pay the money yourself. You do not need the NHSC if you are doing it for financial reasons.

Finally, keep in mind that it is considered taxable income, so you will have to come up with money to pay taxes on whatever amount they give you at the end of each year, which is not easy for a student.

I just wanted to give you guys a personal account from someone who has been there and encourage you not to sign up for the NHSC! You will be able to pay off your loans, but please don't limit yourself or risk damaging your personal life in the process.

 

So I have seen atleast a half dozen bad reviews on the NHSC scholarship program, but I am wondering if anyone has any experience with the loan repayment program? I'm hoping that this might be worthwhile opportunity for me when I finish residency (i'm just a MS-3 so that will be awhile).

 

Hi, Does anyone have the application pdf that they tell you to download and complete after you submitted the online app? My comp crashed in the middle of downloading it and I can't access it. ><

 

Are you talking about the BCRSIS Receipt of Submission (i.e. your banking information)? If so, you can try filling out the form at this website:
https://nis.hrsa.gov/BANKLOGIN.ASPX

If that doesn't work, here is what the NHSC advises you to do:

If you are referring to the contract pdf, try calling the HRSA call center too, and ask if they can send you another copy. When you sign it, just be sure to sign it for EACH year that you're requesting the scholarship - don't just sign it once and assume that they'll understand what you mean.

Hopefully this helps.

 

thanks smq123 =).
I was unclear. >< I meant the AIB (aaplication informational bul.) supplementary that is only downloadable immediately after you submit the application. There's the general AIB on the site, but that has all Sample pages only.

 

Oh, I see.

Yeah, I'd still call the NHSC help line anyway. They'll probably be able to help you faster than we can.

Good luck!

 

I'm really loving this thread. I'm a current D1 and am going to apply. I was hoping a dentist in the NHSC could share their experiences. Thanks!

 

Has anyone had any POSITIVE experiences with the NHSC scholarship? If so, what specialty are you in now and what was your process like (from beginning of med school to your current service)? Basically, what did you do to make sure you got the most out of the scholarship?

Also, if you submit the application and the supplemental materials, get accepted, and change your mind, you're allowed to decline right? What do you have to do in order to decline (before September 30th I suppose). I figured I might as well apply since I am interested in primary care now (and the application was a lot of work!). I know my mind can change during med school. That's why if I were accepted, I may consider declining and applying in my 2nd or 3rd year based on what has been said in this forum.

 

I have a few questions for everyone...
I just applied for the scholarship today, and I am wondering how excited I should actually be.
Would anyone mind sending a profile of what their successful application "looked like?"

Thanks!

 

Thanks for all the honest info. The scholarship has been something I'm considering for next year. I'm wondering if anyone has heard of anyone completing their service commitment, and then doing a fellowship to specialize? I'll be starting med school next year and I'm not sure if this is a totally ridiculous concept because I don't know as yet how residency and fellowships all work exactly. I think I want to specialize, but if I could get med school paid for, then serve, then specialize that does not seem so bad.

 

It depends on what you want to do a fellowship in.

SOME fellowships are accepted under the NHSC - almost all of these fellowships are after family med, although I believe you can do child psych after a psych residency. None of the internal medicine fellowships are accepted.

As to whether or not you can go back and do a subspecialty fellowship after your NHSC commitment - that definitely DOES happen. Many people practice general medicine for a number of years before going back into fellowship - some are just not ready to do more training after being a resident, some want to make a "real salary" for a while, and others just realize later in their career that they want to specialize.

How easy that can be to accomplish, though, depends on a number of factors. Many of the more competitive subspecialties (such as GI or Cardiology) prefer to accept fellows who are fresh out of residency, so having had that much time off (4 years in your case) can be problematic. Other fields, such as rheumatology, allergy and immunology, and ID, are not as rigid.

What field (out of IM/FM/psych/OB/peds) were you interested in?

 

I'm interested in IM with an ID specialty. However, I know my interest may change dramatically during med school, thus I'm weary of the NHSC scholarship, and from the looks of this forum rightly so. My school is very expensive and the thought of getting it free is appealing, but I'm thinking I should leave myself open and seek loan repayment incentives after school.

 

Hi:

I was wondering if anyone knows about the notification timeline for the 09 NHSC Scholarships. During one of the early spring conference calls, the call leader had mentioned that the applicant bulletin had the old timeline, and that they planned to notify recipients in early May. Has anyone heard?

Thanks!

 

I heard him say that also. However, I'm under the impression that the NHSC scholarship is offered on a rolling basis. Some people may have already been accepted, while some others may have to wait until August/September. I could be wrong though.

 

Hey!

I know it's been ages since anything was posted on this board...but if anyone is out there, have you heard anything about the NHSC scholarship yet?

 

I was hoping we could get a positive in depth story about NHSC... I really want to do peds and checked the sites in MO and many are in inner city st. louis or 30-50 west of st. louis so it seems like a good deal. I am only planning on having the scholarship for my first two years of med school.

 

I am a very long time lurker here...or used to be. As an attending for the last 3 years, I don't see much of a need for this board, but it is fun to laugh occasionally.

That said, I am a NHSC scholar who just finished a 3 year commitment. I am still working for an IHS site in Arizona but will be moving on soon, to get "off the reservation".

First off, the financial impact of the scholarship can not be underestimated. Each year that they paid for was ~$50K, so about ~$150K in the end. Add that to the $60K I took out for first year and "to live", is >$210K. Figure in interest, over 30 years and we are talking real money to pay back. As it is, I own $43K now. To be paid of in 15 more years at $235/month, versus $900/month (for 25 years) if no assistance. Trust me, that makes a difference when you add in a car, house, insurance, college saving plans for the kids, etc....

Secondly, wake up! This is a government run program and will not be easy or user friendly. LET ME SAY IT AGAIN....NOT USER FRIENDLY. So please, keep that in mind. But remember, it is better to beg forgiveness then ask permission.

Third, if you sign the agreement and take the money, realize that getting out of it will cost you. A lot. But it can be done. We all change our mind, but a 3-4 year experience in primary care will not make you a worse person and might actually make you a stronger/better physician. So you want to be an oncologist? Great, do your time and take a fellowship after your commitment. That way you can be a fellow and not have to moneylight on all your free weekends to pay your $1000 loan payment every month on top of your other payments.

I work for the IHS, which started me off on a lower salary but I now make more than most of my private practice primary care friends. And work 45 hours/week. And walk home for lunch. And have had an experience that I will always remember and encourage other physicians to try, if just for 1 year.

In the end, I think that the government should expand the program. That way all medical students should have the opportunity to take payment for under served primary care. We have all gone through medical school and residency and 2 years in an under served clinic, however poorly run, should be a cake walk.

Needed to get that off my chest. Thanks.

 

I'm doing a 3 year commitment too as a NHSC scholar- but as either a GP or pediatric dentist. I'd like to get an idea of how much my starting salary will be and how much it can increase over the years. What was your starting salary? (I'm aware that you worked in a IHS reservation- and that the IHS tends to be generous in terms of pay.) Also, do you have friends who worked as NHSC scholars at other sites- and do you have an estimate on what their starting salary was? Thanks.

 

First off, all salary experience is individual. Of course.

Secondly, the IHS is really two types of 'institutions'; the first federal and the second 'tribal'. Federal IHS sites are run by the government and answer to Rockville and have a federal payment system, the 'GS' system. Tribal basically means a 'private' institution, where the tribe/tribes run it how they see fit, with the IHS giving them a lump sum to dispense patient care. They are not required to follow federal rules for payment, etc. So there is a lot more flexibility with a tribally run clinic/hospital, but it is missing the oversight that the government run places have. Either a pro or a con, but best left for another time.

My experience is from a federal IHS hospital/clinic in the Southwest, which if you look, could be 1 of about 8-10 places. I will leave it at that. After finishing residency in a 3 year PC program, you start as a GS-13. This plus "special pay" started me at $110K. After 1 year of work, I got promoted to a GS-14, which was a ~$14K raise. After another year, got the final promotion to a GS-15(highest 'rank' you can be promoted to), which was ~$12K. Then after that you get yearly raises or 'steps' for years served. That said, this is still a job and you still have the right to ask for a bigger raise. And people do. And given the fact that there is such a shortage of people who are willing to work for the IHS, starting pay has increased significantly. Now people starting at GS-13 are being offered $135-140K. A difference of $30K in 3 years, from what I started at.

A friend of mine is a dentist where I work and I believe he was started at 100K, but has since gotten a raise to $130K, after 2 years. I don't know what GS he is, but I would guess a 13-14. Pediatric dentists might make more.

The salaries around the southwest are very similar for all federal sites, since they all have to use the same rules. The one place that is tribally run does pay more, about $25K to start, for physicians. Not sure how their raises work.

Don't forget, you can alway go Corps. For dentists probably doesn't work out financially, unless you put in your 20 or become an endodontist, but for physicians, it might be worthwhile even for a few years.

Hope that helps

 

For the NHSC scholarship program, is it in the contract that you must do your residency at an NHSC approved site (on top of being in an approved specialty)? Or does your obligation begin after you complete residency?

 

Your obligation begins after you finish residency. You can do residency anywhere.

 

I just got into med school for class of 2014 and I know without a doubt that I want to do something in primary care. I am looking at my options for finaid and really like the prospects of this program considering I want to work at the very least 2 years in an underserved area regardless of a required committment. I heard its really competitive to actually get the scholarship? Can someone pm me with information or advice?

 

Hi smq123,

I have applied for the scholarship wanted to know the method they use to notify their applicants of their dicision. Is it by regular mail or by e-mail? All correspondance have been via e-mail form their side. I have been chosen as one of their finalists but I have not heard back from them. They were supposed to let me know by September 30th.

Thanks

Curie

 

Hi,

I wanted to know how do they send acceptance notification. Is it via e-mail or regular mail?

thanks
curie

 

According to the facebook NHSC group, there have been a few people who have called into the main office and asked. Apparently they sent all the scholarship awards by regular mail on the 30th. Depending on where you live it will take 2-4 business days so most likely Tuesday or Wednesday. Apparently a very small percentage of the people who will be awarded the scholarship were even sent a finalist email. They said if you are not a scholarship winner than you will receive notification by regular mail but it may be as late as the end of October. So whatever address you have as your mailing address... make sure you check your mail.

 

Dear all,
Even though it is a long time from now, being prepared is far better than not being prepared. I will be starting a D.O school in the fall and was wondering if you could give me some advice in this matter. Right now I am not sure whether to do primary care or speciality, and waiting for 3rd or 4th year to decide is also a long time from now. I would like to save as much as possible in terms of medical school costs and loans and this scholarship provided by the National Health Service Corps allows me to do so but the catch is I have to do primary care residency and work in an underserved community for 4-5 years. In primary care I am interested in Internal Medicine, and the specialties I am interested are pulmonary or even nephrology, subspecialties of internal medicine. I don't now whether I will end up liking working in the primary care field or not but if I did wanted to subspecialize after my four year NHSC commitment then is there a way to do so and how competitive would it be in terms of specializing after working for 4-5 yrs in the primary care field? Do we retake exams such as comlex/usmle. I am stuck in a predicament right now, I know that if I receive this scholarship I would be limiting myself to only primary care however I figure fields like internal medicine provides subspecialty options. Right now I don't know whether to opt for (option 1) which is to save costs, apply for the scholarship, be restricted to primary care specialities only,work for 4-5 years after residency and if discontent apply for subspeciality OR (option 2) get the loans, don't apply for the scholarship, keep my options open for residency, and if I end up choosing a primary care field then apply for loan forgiveness programs...ugh I am stuck right now in a dilemma...don't know which would be the better option. Please help!!!

 

Thanks for your views.

 

I was in the NHSC loan repayment program after I completed my psyc residency. It was only part of the draw to the job as I had already accepted the position before the site was fully approved.

This was in 2001 when the application process was much more time consuming and the taxes were paid to you directly. I was placed on a waiting list and was approved only after someone else's agreement must have fallen through.

I got 2 years paid up front, getting the check 6 months after the approval. So, I paid my regular loan payment amount for that time and never paid another cent. It took 7 years total to pay off my entire debt. The yearly updates were easy and they also started paying the IRS the tax money directly.

My only problem was the first year. I did all taxes correctly, but got a letter from the IRS. They had accidently added the total amount from NHSC twice and were looking for tax, interest and penalties for the mistaken amount. I sent a nice letter pointing out the incorrect math and it was over.

It's a great program if the job site is a good fit for you.

 

I haven't got a good feeling how it might work out working in a Health Professional Service Area but not working in a designated community site. For instance, if I worked in a HPSA but for a private clinic, I could have that clinic apply for approval.

The places where I would really like to work all have HPSA scores of 15 or greater. If I could work in a private clinic with some control over my schedule in one of these shortage areas, what would be the likelihood that I could get loan repayment for that?

I'm in psychiatry and going into child psychiatry.

 

Quick question about this scholarship:

My residency program location just got designated as NHSC qualified including one of the clinics we work out of as part of my resident traning. Entering my 4th year of residency I have the option of electing inpatient or outpatient work. If I elect to work at this NHSC approved outpt clinic as a 4th year resident (having a full medical license), would I be eligible to start the NHSC program?

Nevermind - found the answer:

Can I receive financial support from the NHSC SP or service credit during my postgraduate training?
Scholars do not receive NHSC SP financial support nor do they incur additional NHSC SP service obligations
during any type of postgraduate training. Moreover, periods of postgraduate training are not credited toward
satisfying the scholarship service obligation, even though the training may occur in a facility located in a HPSA.

 

I don't know, for sure. I wouldn't be super optimistic, to be honest. I've heard, anecdotally, that this can be one of the most difficult options to pay back your service commitment. I've heard from a few people who have tried to make this happen, and weren't able to make it happen, for one reason or another. It really depends on how willing the private clinic is to jump through the hoops to become a qualified site - it's a lot of paperwork.

Good luck.