Navy HSPS

[TryingToDoc]

I've been reading the cons thread for military medicine but none of the information seems to be, at least, a couple years old.

I'm entering med school in a few months and seriously considering accepting the HSPS if offered. My most important question is, does anyone feel like doing military match and active duty service made less well trained as physicians? As well, I'm nervous of the idea of not getting a residency and doing four years of GMO and then out. Is that a realistic fear, or ungrounded?

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[SirGecko]

Typically the information doesn't get outdated quite that quickly when talking about general impressions. Specifics will sometimes change but your question is pretty undifferentiated.

1. Do you mean HPSP? I am assuming you just did a letter reversal on accident.
2. Which service? It matters for the answer to your question.
3. To answer your question it totally depends on what you are trying to do. Sometimes the match pushes otherwise competetive people out of the speciality they want. A much smaller pool, greater variability in match demand signal can mean someone who would match for say ER in the civilian sector won't in the military. That said I have seen it go the other way as well. (Though not as often) In general the military residencies provide good training. You will have issues with volume and acuity in some specialties and these issues can occur as an attending as well. Your likelihood of doing a gmo residency will be far greater in the Navy than the Army but it's a possibility in any of the services. Continue to read the forum and really get an idea of what you are signing up for.

 

[Gerudo]

There are many topics to discuss regarding whether or not you should join. Specifically for the Navy, you must understand that you more than likely will do a GMO and very possibly may not be immediately taken back into a residency after your first GMO tour. This is something recruiters in the Air Force and Army likely emphasize, whereas recruiters in the Navy likely downplay significantly. Being in the military is much more volatile than one may think, your lack of autonomy goes beyond simply having to move every few years.

For example, the Navy HPSP class of 2017 was told all students must apply through ERAS because they did not have enough intern spots for the number of total applicants. This has not been the case in recent history. In fact, previous years for any specialty that does not have spots for deferments were explicitly told not to apply to ERAS. We were told this with minimal advance, only a few months before applications to civilian residency programs were submitted.

If you have a strong desire to be in the military in order to have served your country and would not be able to live with yourself having never joined the military in any capacity, then join. If you simply think it might be a good idea to join considering the financial benefits, then I think you should reconsider.

 

[TryingToDoc]

@SirGecko I did switch the letters, my mistake. I am speaking about the Navy in particular. I'm more concerned about being forced to do 4 years of GMO and then having to find a residency afterwards.

@Gerudo I specifically asked the recruiter with whom I'm speaking, about the chances of not getting a military match and then being forced to scramble to find a civilian residency. She said she's not seen it happen, but hat doesn't mean it doesn't happen.

 

[SirGecko]

@SirGecko I did switch the letters, my mistake. I am speaking about the Navy in particular. I'm more concerned about being forced to do 4 years of GMO and then having to find a residency afterwards.

@Gerudo I specifically asked the recruiter with whom I'm speaking, about the chances of not getting a military match and then being forced to scramble to find a civilian residency. She said she's not seen it happen, but hat doesn't mean it doesn't happen.

I would assume if you do navy that you have roughly a 50/50 shot at having to do a gmo tour. Doesn't mean you have to do four years and get out, could return to the navy match sooner than that. (Though that would likely result with you being in the military longer if the even let you do what you want to do) Again this sort of depends on what you want to do.

As to Gerudo's point about the class of 2017 being told to apply to ERAS: I know they pushed people out to the civilian match for intern years in the previous years as well. (And some with no warning, they were sending emails out in November telling people to get an ERAS application in) That the poor communication on that continues is not very surprising. (And the answer the recruiter gave about not having seen a case is not surprising as recruiters are not involved in the match and would have no experience to speak from to answer that question)

 

[IlDestriero]

Nothing significant has changed.
At best, .mil residencies are average. Are you a superstar? Do you think you might be? It's hard to say because I took not just a little bit of pleasure in watching several elite college high flyers with big egos descend into mediocrity during the first 2 years of medical school. If you're MGH material, you'll find the .mil probably let you down. HOWEVER if you're doing something like primary care it's probably not tremendously different. Often research opportunities are limited and mentorship can be transient 2/2 shifting of the staff. Having said that, depending on your specialty, and motivation, you can probably still do fine, particularly if you want to do a civilian fellowship.
If you're after a big academic career with research goals and dream of teaching med students/residents/fellows the .mil isn't the best place to start your career (with some limited exceptions).
I worked at a couple big baller academic medical centers and at the Starship of Navy Medicine in San Diego. I can tell you without exaggeration that my worst days in San Diego were fairly equivalent to my average days at the Big House. Everyone gets some sick patients and tough days, but the acuity and routine cases were an order of magnitude higher at the premier civilian referral centers. That may not matter for many/most physicians (FM, EM, Gen Peds, IM, etc.) but it DOES matter in the specialty and subspecialty world. You want routine exposure to that complexity and the associated challenges as a trainee. It makes you salty. Any dumb ass can do an appy or a lap chole or whatever routine procedure, and you can learn tricks to improve things like speed and turnover. But when you're out on your own and the **** hits the fan, or some real train wreck comes through the door for an emergent procedure, you yawn and get to work knowing you've taken care of worse.
Search your soul, evaluate your chances at superstardom, ponder your long term goals and roll the dice.


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Il Destriero

 

[TryingToDoc]

@SirGecko I am not opposed to doing a GMO tour as long as I am able to get a residency at some point as well. My main concern is not being able to get a residency and having to find one in the civilian world after I've already done all of my active duty service.

@IlDestriero I'm not a high flyer looking to have a big prestigious academic career. I would call myself a grinder. I'm older, early 30s. I've spent time overseas in the Peace Corps and spent the last few years taking all the pre requisites for med school while working 60 hours a week. I'm looking at IM and or psychiatry at the moment, but that can always change. I'm from a small, rural and poor area, I want to be well enough trained to return to the community and practice and give back.

 

[SirGecko]

@SirGecko I am not opposed to doing a GMO tour as long as I am able to get a residency at some point as well. My main concern is not being able to get a residency and having to find one in the civilian world after I've already done all of my active duty service.

@IlDestriero I'm not a high flyer looking to have a big prestigious academic career. I would call myself a grinder. I'm older, early 30s. I've spent time overseas in the Peace Corps and spent the last few years taking all the pre requisites for med school while working 60 hours a week. I'm looking at IM and or psychiatry at the moment, but that can always change. I'm from a small, rural and poor area, I want to be well enough trained to return to the community and practice and give back.

If your goal is to get to an IM, family or psych residency it would be reasonable to think this would be achievable assuming you don't majorly screw up along the way. Again you might wind up needing to do a gmo tour but as long as you are moderately competitive this would likely be achievable.

 

[TryingToDoc]

If your goal is to get to an IM, family or psych residency it would be reasonable to think this would be achievable assuming you don't majorly screw up along the way. Again you might wind up needing to do a gmo tour but as long as you are moderately competitive this would likely be achievable.

That's what I'm looking for. As I said, I'm older and just now starting the process. I'm looking for solid training that will allow me to come back to my community and give back through practicing medicine. A hyper specialization such as pediatric cardiology isn't something needed a ton around here. Things such as psychiatry for substance use disorders and general internal medicine doctors are.