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Navy and AF HPSP Q's

Discussion in 'Military Medicine' started by balrog26, May 15, 2007.

  1. balrog26

    balrog26 10+ Year Member

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    So, I've been reading extensively on these forums for the past few weeks about the HPSP. I understand the current state of military medicine is in decline (in some of your opinions is in a state of disrepair worse than the CA public school system, haha). I've sort of set my sights on military service at some point in my life and have decided it would be good to do so as a physician.

    A few questions:
    1) Why is the AFHPSP so competitive? What is it about AF quality of life that's so much better (their residency hospitals don't look that great and their tours seem to have just been extended to 6 months for physicians)? This is really my only question about the AF

    I'm sort of seriously looking at the Navy, however.
    2) What are the odds of the GMO ceasing to exist by 2012?
    3) Is it possible to go straight through from the FYGME to residency (specfically to IM)?
    4) Is it possible to become an FS after completion of residency? I really like the idea of being an FS, but the extra money from a specialty would be appreciated.

    If things worked out in my convoluted plan I would go Navy with a three year HPSP straight through from FYGME to the remaining two years of an IM residency, do 3 years as an FS (6months training, 2 years FS, and then spend the last 6months on base applying for cardiology residencies and use my terminal leave), get out, and become an interventional cardiologist. Is this possible?

    Thanks for any response and I hope not to cause any arguments about milmed.
     
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  3. balrog26

    balrog26 10+ Year Member

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    One more thing that I forgot.
    I've read that the 0-4 rank in Navy (Lt. Cmdr.) is still considered a jr. officer, while 0-4 in Army, AF...(Major) does not. As a result, an Lt. Cmdr. rates fewer privileges than his say Major counterpart in the Army. Is this a big deal and what kinds of privileges are they?
     
  4. BigNavyPedsGuy

    BigNavyPedsGuy Junior Member 10+ Year Member

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    1) it's not competitive. If your recruiter says it's competitive he's blowin' smoke
    2) your guess is as good as anyone elses. Supposedly, it's been rumored to be on the decline. I hope it's phased out by summer 2008 :D
    3) yes it's possible, but who know what will be going on in 2012? I signed up when this little skirmish in Iraq was 6 months old and I believed the "mission accomplished" stuff.
    4) I think that when you're a flight surgeon you get paid the same whether you've finished a residency or not. I also think the plan of spending hte last 6 months on a base then getting out, might not fly with the dtailers. Most assignments are going to keep you there longer than 6 months.

    You're asking good questions - I can tell you've been doing a little reading
     
  5. Mirror Form

    Mirror Form Thyroid Storm 10+ Year Member

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    It's not that competitive, but it's more competitive than army and navy. That's b/c they get air conditioning in the desert, and have shorter deployments. Army and Navy frequently deploy certain types of physicians for 12-15 months (not the real surgeons though, fortunately). Chair Force also just seems to be better organized in general.

    Don't count on it. Although the army has been doing away with them slowly, the navy and air force are still going strong with them. At this time there is no end in sight.

    Yes for IM. Unlikely for certain navy and air force specialties. Likely for almost all Army specialties.

    Yes, but it's not desirable. That may sound good when you're a premed or a med-student. However, as you train you'll find that you learn a heck of a lot in residency that you won't use as a flight surgeon. Theres too much to know in medicine to remember all of it w/o using it. Therefore, you'll lose some of your skills over your 3 year FS tour. Also, so much changes in medicine in 3 years that you may also get a little bit out of date too. If you're lucky enough to be somewhere where you can moonlight, that might not be such a big issue. Still, after your finish training to be a fully certified IM doc, you're not going to want to take a step backward to function just as a flight surgeon.

    Well, cardiology fellowships are competitive. So don't expect to land a good slot after doing a 3 year FS tour. You'll need to have research and publications.
     
  6. mitchconnie

    mitchconnie Member 10+ Year Member

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    I wouldn't call the AF "competitive." I think it's more like "less desperate."

    Historically the AF probably did have a little better quality of life--nicely manicured bases, nicer base housing, better golf courses, shorter and less frequent deployments, etc. Plus, I think a lot of people have the impression that the AF is the "gentleman's service" (my recruiter's words): better educated personnel overall, less chance to get shot at, more laid back, easier PT...sort of less "military."

    Plus, it used to be that the AF had the highest chance of civilian deferment for residency, and the least chance of getting forced into a GMO. So the AF has a lot of residual prestige accumulated years ago.

    But speaking as someone who bought that line from the AF recruiter, all of the above is BS. Deployments are now 6 months, same as the Army surgeons. Everyone lives off-base, so nice on-base housing is irrelevant. Accommodations while deployed were virtually identical between Army and AF, and we got shot at right along with the Army and Marines. And if you look at recent AF match results, you will see that the AF actually is forcing a lot of students into a mandatory GMO tour, and giving out fewer deferments.

    Lastly, the AF clearly has the worst medical service overall given the downsizing that they have done recently. Having worked at Army, Navy, and AF hospitals, I can tell you that the AF is the most frustrating and bureaucratic.
     
  7. AFDuck

    AFDuck 7+ Year Member

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    Is there any actual data of how many AF GME applicants are getting forced into GMO/FS? In other words, does every AF GME applicant show up on the published match lists (whether it be a categorical residency or a just FYGME match)? I would assume that most everyone just getting a FYGME slot would be looking at a FS/GMO tour afterwards, correct?
     
  8. NavyFP

    NavyFP Senior Member 10+ Year Member

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    Manning a Cubicle
    There is no difference in treatment between a Navy O4 and an Army/AF/Marine O-4. They just get the extra gold on the visor of their combination cover. Jr./Sr. officer is purely traditional.
     
  9. IgD

    IgD The Lorax 10+ Year Member

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    I'd say zero.

    It is possible but unlikely.

    Yes it is but you have to complete a utilization tour after residency first.
     
  10. Ex-44E3A

    Ex-44E3A 7+ Year Member

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    Ahahahahah! *snort*

    Whew! Where was I? Oh yes...

    1. Got a pulse and a med-school acceptance letter? (and you're not 400lbs, openly gay, a convicted felon, or medically-disqualified?) You're "in like Flynn." The "competitiveness" of HPSP is a phantom... it's not real.

    2. GMOs are going to be around for quite some time. The services have been paying lip service to getting rid of them, but it's not happened yet.

    3. Good possibility they'd let you do IM straight-thru... but beware! There's that whole "needs of the Air Force" thing; it's wholly unpredictable, and can bite you at critical moments in your career.

    4. Why would you want to do Flight Medicine as a fully-boarded doc? It will simply have the effect of "dumbing down" all that hard-won knowledge you just acquired. As a residency-trained internist, your clinical skills will get duller every day you practice as a flight surgeon. It's a great gig for a young, single doc (and flight suits do get chicks), but few people do it as a career. There are guys out there who love flying and deploying so much that they stay in a flight doc slot forever... but unless you're one of those, avoid it.

    Also, Navy FP is dead-on right... they'll probably make you re-up to attend the AMP course to become a flight doc. If you wanted to further pursue it, you could become a RAM, and if memory serves you'd have to do at least a year as a flight surgeon, then re-apply (and you'll owe three more years after completing your Residency in Aerospace Medicine).

    Do FAP... there's absolutely no reason to do HPSP. None.
     
  11. balrog26

    balrog26 10+ Year Member

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    Thanks very much folks. I'd been trying to find the answers to some of these questions for days (and when I do research, it's rather intensive).

    I sort of liked the idea of serving as an FS (it seemed the most interesting way to serve as a doctor in the military, except as a DiveDoc, but that doesn't suit me too well). What kind of life is it to serve as an internist in the military (I mean I've read all about the poor treatment of doctors etc., but as a Navy internist where would I be serving? In a clinic in the states? On a boat? Not quite sure).

    Also, I have been doing a lot of HPSP research, but not so much on the FAP. What does the FAP entail?
     
  12. TX_NFS

    TX_NFS Steel melanoleuca 5+ Year Member

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    State of Sleepiness
    If you haven't seen this already, this looks like a nice thread to read through: http://forums.studentdoctor.net/showthread.php?t=189443

    Otherwise, two other links that came to mind (for Navy) are:
    http://www.nomi.med.navy.mil/pages/nmetc/information.htm#fap
    http://nshs.med.navy.mil/gme/NAVMEDGME.htm#FINANCIAL%20ASSISTANCE%20PROGRAM%20(FAP)
    From above link:
    "This is an inactive Ready Reserve program for physicians and dentists in civilian graduate professional education programs. Participants are appointed as commissioned officers in the Naval Reserve. Tuition, fees, books and other educational expenses are paid by the Navy. Effective 1 July 2006, participants receive a monthly stipend of $1,319 and also receive an annual grant of $27,841 (before tax). FAP participants incur 2 years obligation for the first year and ½ year for each additional ½ year or portion. Obligation is additive to other unfilled obligation."

    Good luck with your choices. I'm pretty much in the same boat right now as well.
     
  13. megadon

    megadon 5+ Year Member

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    Yeah, it's true, but it doesn't matter. If you are working with the Army or Air Force, and maybe even the Marines, you get whatever extra benefits there are (which I am unaware of). However, you do have the privelage of having to own all the extra uniforms required of senior officers, and having to own a sword. If you are ever with the brits, you get senior officer status too. You don't get scrambled eggs on your visor until 0-5 in the Navy.
     
  14. sethco

    sethco Senior Member 10+ Year Member

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    This is not hard to figure out, but does take time and patience. What you have to do, assuming you can find the previous year's match results, is find everybody that was given a transitional year only and deferred. All of these people will become GMO/FS since they are not allowed to reapply to the JSGME (Which is clearly stated in the instructions of the AF JSGME application). This means they will not be allowed to apply during their internship year, although this was allowed in the past (Knew a couple of people that originally were shut out of Ortho that made it the following year when the number of residency position "magically" doubled for no reason whatsoever). If memory serves me correctly, this number has been hovering around 20% of all applicants for the past couple of years. Keep in mind that this 20% does not include all of the applicants that were currently serving as a GMO/FS or other specialist that were applying through the JSGME that still got denied residency positions. Before anybody objects to this, it does and has happened. I know personally 3 people that applied that were FS and got denied (2 were going for Derm, 1 for Anesthesia). I have been convinced that there really is no rhyme or reason how they choose who gets what and have given up on military GME. I am just serving out my time as a FS and then entering residency after 4 years and I am out for good. Hopefully, no stop-loss or IRR call up in my future, though. :mad:
     
  15. balrog26

    balrog26 10+ Year Member

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    Quoting Ex-44E3A:
    "Do FAP... there's absolutely no reason to do HPSP. None."

    So after reading more on the FAP, why would it be better than the HPSP? If one were to do three years of HPSP that totals to 3 yrs. med school tuition + stipend (w/interest that's as high as $245k) and then a military residency in IM (about 15k more per annum than civilian) followed by 3yrs service, it would seem to be much more monetarily beneficial than owing 4yrs for a 3yr residency which only gave you an approximate amount of $154k.

    Just curious. Thanks.

    Also, what's the chance of getting a civilian deferment on a cardiology residency right after IM? I know it's unrealistic, but it would definitely help with the pay when I finally got 'round to paying off the military obligation.
     
  16. sethco

    sethco Senior Member 10+ Year Member

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    This has been talked about on numerous occasions why FAP is considered superior to HPSP. In my opinion (and you read my previous post above for the reason), its superior because you don't have to go through the GME board process. If you are a very competitive student and may have been able to get a Derm/Optho/ENT/Plastics/Urology/Whatever residency as a civilian, the chances of you getting this residency straight out of medical school is extremely rare, especially if you are an HPSP student with no prior military experience. You will first have to serve as a GMO/FS before being even being considered. Secondly, with the number of hospitals that are downsizing and the move toward more operational medicine, the residencies are only going to get more scarce. By doing FAP, you are more likely to get the competitive residency if you do well in medical school. It seems that the JSGME does reward HPSP students for doing well in med school. I've seen people with 240+ on boards and near top of their classes get denied for residency. At least with FAP, you are already residency trained. In my opinion, this is much more valuable than the nay monetary difference between FAP and HPSP.


     
  17. Ex-44E3A

    Ex-44E3A 7+ Year Member

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    I wasn't talking simply about numbers. Doing FAP has an enormous advantage over HPSP, and it's one that's not calculable in dollars. By delaying your military decision until later in the process, you will have a much better idea of specialty, income versus debt level, life situation, marital situation, etc, etc.

    Don't underestimate the value of that... it's HUGE.
     
  18. g293

    g293 2+ Year Member

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    A big AMEN to that. You can't put a price on doing the specialty of your choice at the program of your choice. How ahead would you be $$ wise if you had a 2-4 year delay in entering the specialty of your choice, perhaps at a substandard or less than ideal training program?
     
  19. balrog26

    balrog26 10+ Year Member

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    Thanks for all of the information. These were really the only questions I had about the program after doing my research. I appreciate the answers.
     
  20. deuist

    deuist Stealthfully Sarcastic Physician Lifetime Donor Classifieds Approved 10+ Year Member

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    There is hard data, but I won't reproduce the match list here since it contains personal information of every airman who applied for GME. This year, 23% of medical students were thrown into the FS/GMO route. 23%! While there might be some students who wanted to wanted to become flight surgeons, there is no way that 1/4 of the Air Force's HPSP recipients wanted to give up on residency.
     
  21. BomberDoc

    BomberDoc ex-BomberDoc 2+ Year Member

    Preach on, brother! This flies directly in the face of the "98% of people get their first or second choice for residency" lie that the AF is STILL telling. I consider it my personal mission to discourage as many people as possible from stepping into the trap that is HPSP.

    Balrog, keep your options open. Do med school and residency as a civilian and don't worry about taking on some debt. If you still want to serve, you can do so with FAP and have a lot more control over your life. As has been said dozens of times, if you are joining for the money, you shouldn't be doing this. Unfortunately, most of us learned this lesson the hard way after we already signed away our freedom.
     
  22. NavyRecruiter

    NavyRecruiter Navy Mustang

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    Thanks to everyone for all the great information about the HPSP program. Without repeating my entire introductory post, as my avatar states, I'm a realitively newly assigned HPSP recruiter in the Los Angeles area and I'm trying to learn all I can about the program. You folks are helping me out tremendously. :bow:

    The questions (and answers) are great, and I'm learning a lot.

    If any of you have been through the Navy's program and have any specific advice that you wished your recruiter would have shared with you, please let me know so I can share it with my prospects.

    Thanks in advance for all that you are going to teach me about YOUR world. If I can ever be of service to any of you, please let me know.

    Thanks!
     
  23. The White Coat Investor

    The White Coat Investor AKA ActiveDutyMD Physician Partner Organization 10+ Year Member

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    While we are glad you're here, I'm a little bothered that you have to come here to get the details on the program and that they aren't provided to you elsewhere. I suspect my recruiter was the same way as he gave me much misinformation back when I signed up.
     
  24. mitchconnie

    mitchconnie Member 10+ Year Member

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    So...Let me get this straight. It's your full-time job to sign up the best and brightest students in the country to a contract that will obligate them to serve for a large part of their professional lives--and you are getting your information from an anonymous internet forum? Tell me where I'm wrong here. Please...Please tell me that this is some kind of disturbing aberration and not the norm for recruiters.
     
  25. Mirror Form

    Mirror Form Thyroid Storm 10+ Year Member

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    It's not the recruiters fault that he isn't given the appropriate information about med school and hpsp when he starts recruiting. That's the system. At least he's on here learning unlike some others.
     
  26. mitchconnie

    mitchconnie Member 10+ Year Member

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    Oh...and by the way. As my avatar states, I'm a relatively newly assigned vascular surgeon and am doing a big Thoraco-abdominal aortic aneurysm repair tomorrow. I've never done one before, but I knew you guys on this forum would have some great information. Let me know if you have any tips. Thanks in advance.
     
  27. Gastrapathy

    Gastrapathy no longer apathetic Physician Lifetime Donor Classifieds Approved 10+ Year Member

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    my nominee for "post of the year."

    seriously mr recruiter, you're 2 hrs north of one of the biggest Navy hospitals in the world. How bout you head down there and see for yourself. in fact, bring your hpsp wannabe's with you and let them talk to a smattering of POST-GME physicians.
     
  28. West Side

    West Side 5+ Year Member

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    :laugh:
     
  29. BomberDoc

    BomberDoc ex-BomberDoc 2+ Year Member

    Point them to this forum and encourage them to talk to current active duty docs.

    You are brave to post here. I hope thick skin is a pre-req for recruiter duty. Most of us would love to get our hands on the guy who got us to sign up for HPSP. Oh, and be sure to pass on your aneurysm repair pearls to mitchconnie.
     
  30. Ex-44E3A

    Ex-44E3A 7+ Year Member

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    I'll give props to any recruiter willing to walk into this lions' den.

    NavyRecruiter:

    I don't envy you. You've been asked to sell a marginal (at best) product, by a company that blatantly treats its physician recruitment as a numbers game. Recruiters are expected to keep the HPSP treadmill running while the single-digit retention rate on the other end ensures a constant brain-drain. The only thing that keeps it going is replacing those fleeing docs with fresh meat.

    Unfortunately for the military, that's getting tougher and tougher (and you're caught square in the middle). What percentage of your HPSP scholarships went totally unclaimed this year?

    The problems of milmed are far more than skin deep, and the leadership's failure to address them only kicks the can down the road for another year or two. I don't know how they expect you to sell military medicine (and provide enough accessions to fill the billets) in its current state.

    Incidently, don't be too quick to thank us. Many of us were not fully informed by our own recruiters, and our scathing personal stories and testimony on forums like this make your job much harder.

    It's somewhat refreshing that you don't seem to resent that. Some of your fellow recruiters have a real tendency to shoot the messenger.
     

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