Need Advice

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I was wondering if I could get some insight into my situation.

I did Army ROTC for college and have a 4 yr AD service obligation. I received and educational delay and am attending Medical School at a fairly pricey school. I did not want the extra service obligation, so I did not take the HPSP scholarship and took out loans. I am looking at graduating over $250,000 in debt.

Another reason I did not take the HPSP scholaship was that I wanted my leaverage in applying for a civilian deferment.

I am want to go into hematology/oncology. Given that I will probably have to owe 7+ yrs on AD anyways because of "time in training" obligationof residency plus fellowship, should I go ahead and take the HPSP scholaship?

Thanks for the advice!

 

[Galo]

I was wondering if I could get some insight into my situation.

I did Army ROTC for college and have a 4 yr AD service obligation. I received and educational delay and am attending Medical School at a fairly pricey school. I did not want the extra service obligation, so I did not take the HPSP scholarship and took out loans. I am looking at graduating over $250,000 in debt.

Another reason I did not take the HPSP scholaship was that I wanted my leaverage in applying for a civilian deferment.

I am want to go into hematology/oncology. Given that I will probably have to owe 7+ yrs on AD anyways because of "time in training" obligationof residency plus fellowship, should I go ahead and take the HPSP scholaship?

Thanks for the advice!

Seems like, you did the right thing for the right reason.

I'm sure I will be immediately corrected if I am wrong, but even if have to do a military residency, that payback is served concurrently with your 4 yrs you owe. So you should owe only one more if Heme/Onc is a 5 yr residency.

Do you have to apply to military residencies at all?

 

[Mirror Form]

I was wondering if I could get some insight into my situation.

I did Army ROTC for college and have a 4 yr AD service obligation. I received and educational delay and am attending Medical School at a fairly pricey school. I did not want the extra service obligation, so I did not take the HPSP scholarship and took out loans. I am looking at graduating over $250,000 in debt.

Another reason I did not take the HPSP scholaship was that I wanted my leaverage in applying for a civilian deferment.

Very smart move not doing HPSP. Adding HPSP to ROTC is basically going to commit you to serving out your 20, which is too big of step to take at your stage. And even at an expensive med school like yours, it's probably not a great financial decision. Unfortunatley it will not increase your leverage when applying for a civilian deferrment. You'll be in the exact same boat as the HPSP students. That said, if you're worried about debt then you're probably better off doing a military residency.

Because you paid for med school on your own dime, you'll be credited w/ 4 years of service toward your payscale when you start. So you'll make a phenomenal salary as a military resident (about twice the take-home pay of civlian residents). Also, by excelling in a military residency, you'll be in a better position to secure a slot for fellowship training (the military has to OK you for fellowship, which is more likely if you're a known entity).

I am want to go into hematology/oncology. Given that I will probably have to owe 7+ yrs on AD anyways because of "time in training" obligationof residency plus fellowship, should I go ahead and take the HPSP scholaship?

Thanks for the advice!

The "time in training" obligation works differently for residency and fellowship. Assuming you owe 4 years for ROTC, then you would have to do a RESIDENCY that is over 4 years (NOT including internship) in order to have your active duty obligation extended. Since internal medicine is only 2 years after internship, you won't even be close to having your active duty obligation extended by residency.

Fellowship works differently. I'm not exactly sure how it works if you do a fellowship within the military system. Most military fellows do their training at civilian institutions though (while the military pays) and the extended obligation is 1 year for 1 year (with a minimum of 2).

 

[Mirror Form]

Do you have to apply to military residencies at all?

Yes. In regard to residency applications, he'll be in the exact same situation as the HPSP students.

 

[Gastrapathy]

Most military fellows do their training at civilian institutions though (while the military pays) and the extended obligation is 1 year for 1 year (with a minimum of 2).

The exception to this are the IM fellowships, as the military trains most IM subspecialties within the system. For HO, I know there are at least 2 Army inservice programs (WRAMC and BAMC). The WRAMC program is a combined NCA/NIH program that I think is quite good.

For the OP, if you complete IM residency and then fellowship in the Army, you will finish owing 5 years (which is 1 year more than you would owe for your ROTC obligation). However, if you take HPSP, you'll finish training owing 8 years. The catch is that there is no guarantee you'll get to start fellowship immediately after residency. You may have to do a tour as an internist in between residency and fellowship (and if you don't do an Army residency, count on this happening). If that happens, you'd probably want to finish your obligated service as a general internist and then apply to civilian fellowships.

If you do outservice training for fellowship, you do not pay back your ROTC/HPSP commitment during that period, so this can also extend payback in certain situations...confused yet?

If you take the HPSP scholarship, the 8 years you owe, plus your 6 years of GME will get you to 14 years. If you did choose to do this, you wouldn't need to worry about going straight into fellowship because one tour in between residency and fellowship wouldn't affect your commitment. In a sense, there would be nothing you could do to make your commitment longer at that point, so why worry about it.

If you want out of the Army quickly, your best path is an IM residency (which is one aspect of military GME thats still pretty solid) and then 4 years as an internist/Iraqologist. Good luck.

 

[a1qwerty55]

There isn't obviously a "correct" answer, seems to me like there are 3 basic scenarios

1. You pay your way - do 3 years of IM residency, 4 years of payback (ROTC) and get out to pusue your Onc fellowship. 7 years of service didn't count for anything and now you are starting a Oncology fellowship at a much lower salary, 4 years older than peers, probably with a family and with 250K in debt. The upside is that civ incomes are much more than military for Oncology so you should be able to pay off the debt fairly quickly.

2. You pay your way - do 3 years of IM (I'm making the assumption you don't get picked up out of residency for the fellowship), 2 years of IM, get picked up for fellowship, do 3 years of HO, then pay off 3 (2 ROTC years and one more for the HO fellowship) years (now you are at the 11 year mark and are in the zone for O-5... to stay or not?) hard call. Probably get out but now you still have to pay back 250K.

3. You take 4 year HPSP (total years owed = 8), do 3 years of IM residency, 2 years of IM staff utilization, then 3 years of HO fellowship, now start paying off the 6 years you still owe - (14 year mark O-5 rank, harder decision to stay or go, big question is can you gut our 6 more?)

I don't know which I would do but option one seems appealing. Remember that as far as deployments go, there probably isn't much if any difference in the number of deployments between each option as with option one you can expect at least one and possibly two deployments.

With options 2, and 3 you will not be deployed during training as as the utilization tour is only 2 years, you are probably looking at one deployment during the initial 8 years of service, and then probably one more post fellowship. Frankly no one has a clue what the deployment landscape will look like when you are in the chute, in 7-10 years.

I doubt this cleared much up for you, but I hope it accurately sums up the options.