I don't think you can opt of out scholarship once you accept it. I think you would have to pay back 3 times the amt they give you. In terms of specializing, you could only do that after your repayment period. Some specialties gpr or aegd you might be able to do before, but anything else you should have thought about before accepting unless you plan on going back to school after your service.
That's not true - you can opt out. There are cutoff dates for when you have to notify them that you'd like to discontinue your contract, but you can do it.
In their PDF outlining the program, under the question, "Can my NHSC SP contract be terminated?" the following answer is given:
1) The HHS Secretary or designee may terminate an NHSC SP contract for a school year if, on or before June 1 of the school year, the scholar does the following:
a. Submits a written request to the NHSC SP through the Customer Service Portal to terminate the contract for that school year; AND
b. Repays all amounts paid to, or on behalf of, the scholar for that school year.
If a scholar meets these requirements and the Secretary terminates the contract, no service obligation will be incurred under the contract that was successfully terminated. If a scholar does not meet these requirements, he/she will still have a service obligation for the full or partial year of support received under the contract. The requirements above apply to requests for terminating the initial/first contract as well as any optional contract(s). After June 1, 2016, NHSC SP contracts covering the 2015-2016 school year cannot be terminated.
2)The HHS Secretary or designee may terminate an Optional Contract for a subsequent school year (or years) if the scholar does the following by June 1 of the
subsequent school year:
a. Submits a written request to the NHSC SP through the Customer Service Portal to terminate the contract for the subsequent school year (or years); AND
b. Repays all amounts paid to the scholar, or on behalf of, the scholar for that school year.
If a scholar meets these requirements and the Secretary terminates the contract, no service obligation will be incurred for the terminated contract year. If a scholar does not meet these requirements, he/she will still have a service obligation for the full or partial year of support received under the contract.
For example, a medical student signs contracts for 4 school years of scholarship support through her date of graduation. During the third school year, she goes on
a leave of absence from October 1 through June 30. If by June 1 of the third school year the scholar submits a written request to terminate her third year contract AND repays all amounts paid to her or on her behalf under the third-year contract, the NHSC SP will terminate her third year contract, eliminating any service
obligation for the third school year of support and making her eligible to receive scholarship support for 2 more school years subject to the availability of funds. If, however, she elects to retain the scholarship support received from July 1 through October 1, she would owe a year of service for the partial third year of support received and would be eligible to receive only one additional school year of scholarship support. When an NHSC SP contract covering a particular school year is terminated, the service obligation incurred by the scholar under a prior contract year (or years) remains binding.
3) Prior school year contracts may not be terminated after June 1 of the school year to which the contract pertains
The link for the PDF is here:
http://www.nhsc.hrsa.gov/downloads/spapplicationguide.pdf