Ok, need some help with doubts and decisions - AF HPSP

[PikeMedStudent]

---

Members do not see this ad.

Ok, so I am totally stressed about what to do. I decided long ago to look into the AF HPSP program as a way to pay for Medical School. I'll be attending St. Louis University Medical School next fall ('04) and I know I'll have a major debt. Tuition alone is about $37,500. I added it up and realized that after compounding the interest, I'll accrue a total debt at the end of a 4 year residency of close to $310,000. I've always admired the military and felt that I might want to serve my country but was unsure how to do that best. Thus, AF HPSP came up. I wasn't entirely sure if I wanted to do it and procrastinated some, but finally got my app finished just in time for the last of the decision boards. I went in thinking I could always decide for sure if I wanted to do it later, but I wanted to keep the option open instead of deciding right away. It gave me a chance to see what everything was all about. Since then, I've been flopping back and forth constantly on what to do. Obviously, financially, its a no brainer. I'm going to an expensive private school and if I even consider a primary care specialty, I'll have a major burden. I do have several doubts though...

1. I've never been one to like people having control over my life. From what I hear, the AF is pretty relaxed and I'll likely spend my four years of commitment somewhere in the U.S. without difficulty. But, I've always hated incringements on my independence in my working environments and I'm wondering how I'll do with the military.

2. By the time my commitment comes around, I wonder if my priorities will be the same. I hope to have a wife (and possibly kids) by then and I don't know how that will be affected with my commitment. I don't imagine I'll want to be away from them, but I cannot imagine it would be difficult if they could be with me whereever I go.

3. I know I shouldn't consider this, but the girl I'm currently with (we're pretty serious - going on 2 years) will be a med student as well, but doesn't want to do military. Will it be hard to stay together during residency/post-residency if married by then?

4. Are there any residencies that are absolutely impossible to do with the military? I haven't decided what I want to do, but I have a wide variety of interests.

5. I seriously doubt I'll stay after my four year commitment.

To counter these doubts, I know that for the next 4-8 years of my life, I'll be fine. I'd probably enjoy the COT (although watching the video was a bit intimidating) and I'm not worried about physical requirements because I'm in decent shape. Further, not having any financial stress would be an incredible burden off my shoulders. Finally, if I do end up in the U.S., I'm sure it will be a great opportunity to live somewhere I never would, cheaply. I've moved around my whole life and I adjust well.

At this point, I've been accepted into the program and spent the whole last week agonizing over what to do. My recruiter essentially gave me the week to call him back and set up dates for comissioning and such. As you can see from the time and date of this message, I'm still pretty torn. I've decided about 4 different times what to do, only to hear advice from someone or think certain things over and change my mind. As such, I pretty much need to call him tomorrow and let him know. I already feel bad for waiting this long.

One other thing, I've thought about declining now and, if I still feel strongly or feel that I made the wrong decision, go full-steam ahead for the 3 year program. In some ways, it appeals more - less commitment and only a $50,000 - $60,000 debt eventually. However, I'm afraid that since they think I am going to do this and since I've been accepted, my turning them down will end up hurting my chances for the 3 year program.

Whew! Any thoughts (please!)? 😕

 

[HeavyD]

Sure sounds like you are having to talk yourself into 'tolerating' a military lifestyle in order to gain greater financial security. From what so many posts have indicated on this site, your narrow requirements and big expectations regarding the military will provide you with a good amount of bitterness. There is an abundance of points of views in old threads regarding this very issue. What I mean by narrow requirements is that you will in the military and members of the military are deployed. AF is notorious for staying in the no. American continent as much as possible, but it seems like a great stroke of luck versus the standard when you don't deploy and spend the entire payback stateside. Also, again, you'll be in the military and by oath you will obey the orders of those appointed over you. Chew on that a bit; a senior officer who might be a nurse or hosp. admin. type that found a master's degree on the net. These very well might be your superiors and as such, you are bound to follow their lawful orders. I'll let someone else throw out their ideas for taking the HPSP solely for the money, although it soulds like you have at least a bit of a sense of duty to serve. If you're in it only for the money, look into Natl health service corps. Get to stay stateside and no military life-style issues. This might really test your assertion to your willingness to live in an area you would not have otherwise, however.
That the above for what it might be worth to you.

 

[UseUrHeadFred]

Remember: The purpose of the military is to fight - not to pay for education. Thus, they will always do what is in their best interest long before considering yours. If you aren't willing to make their goal your own, then it is always a bad decision.

 

[militarymd]

read my threads.

Your priorities will change and you sound like you will be unhappy. I was speaking with a surgeon colleague of mine today about military medicine. He was expressing to me about how unhappy he is about being a surgeon in the military, and how he wishes he could travel back in time to tell himself not to sign, or spend some time with college students to tell them not to sign.

Well, I told him about my internet friends I have here on SDN, and how most of the students' priorities are quite different then his and mine, and how, despite my experience, most seems to want to take the scholarship anyways. My priorities/outlook on life were similar to the HPSPers here in the forum, but have changed since then.

With some discussion, we both agreed that when we were your age, we probably would not have listened to anyone with experience and taken the money......then regret it later.

 

[bobbyseal]

Mil Med,

I know you would like to remain anonymous, but is there any chance you can tell us what surgical field you have specialized in?

BTW, I liked your post regarding the naivety of youth. I wouldn't say that right now, I'm upset about taking the scholarship. But, maybe down the road I may. Thus, I may try to go the deferal route, get my training, try not to dumb down too much in those very important post-residency years of learning real medicine, and then get out.

 

[DoctorInSpace]

PikeMed,

I dont' know if you talked to your recruiter yet, but the financial security is not a good reason to take the scholarship. I'm very happy knowing that I have no idea where I will end up, that I could be away from my husband deployed somewhere, that I will serve to protect my country as well as pursue the career I want. That is why I chose the AF scholarship. The financial aspect of it was a perk that went along with all the other wonderful reasons for me to accept the scholarship. There are people on SDN who want to back out while still in med school, wondering what their financial obligation would be. Unless you are 100% sure you want to be in the military, with all of the good and bad things that might entail, I encourage you to NOT take the scholarship, and leave it for someone who is more comfortable with the decision. I really don't mean that to sound harsh or anything...i just don't want you to be another one of those people on SDN that thoroughly regrets your decision.

Best of luck, and let us know what you decide. Even if you don't take the scholarship, i extend my congrats on getting it.

 

[mitchconnie]

military MD's comments about changing priorities really hit home for me.

When I signed up for HPSP, I was a poor college student facing what seemed like insurmountable debt from an expensive private school--about $120,000 total at that time. I was single and didn't have any idea what specialty I wanted to pursue. I just wanted to get through med school and be a doctor. HPSP seemed like a god-send. The prospects of not being able to do a particular specialty, not being able to live where I wanted, or having to be deployed didn't bother me in the least. I was singing the praises of HPSP to anyone who would listen.

My how things change. My wife is now bitter about having to move away from a place she loves to go to my next assignment. The civilian program where I trained is offering me my dream job but I can't accept. Being away from my two toddlers for 3-6 months at a time during deployments to the desert is terribly painful for me. Military practice in my field has totally collapsed and I essentially do primary care. The differential in pay between military and civilian salary in my specialty would pay back that $120,000 in one year. I would give anything to take back my signature from that HPSP contract.

I actually think I got an OK deal from the military in comparison to some of my colleagues, and am not bitter, but signing up for HPSP was clearly the most foolish career decision of my life.

 

[Rudy]

I echo exactly the words of MilMD and MitchConnie. I was accepted into several good state schools that would have been relatively cheap; however, I was married with a newborn child and we wanted my wife to be able to stay home, so I went with the USUHS option (I call it poverty induced psychosis). Now in residency with two small children who hardly know their grandparents, cousins, etc and a wife who desperately needs the support only family can give during residency training, we are 2000 miles from home with no guarantee that we will ever get to be near family during my military career (which unfortunately due to my USUHS committment extends to 2014). If we would have known then how we feel now, there is no way we would have ever signed up; no amount of money is worth it.

Compound these feelings with the ridiculous bureauracracy garbage of the military and the dwindling case volume plaguing military medicine, and it makes for a pretty miserable situation. I fear the worst part is yet to come: being sent to a small base in the AF to have my skills atrophy and die on the vine. Many of the senior docs in my field are no longer competitively suitable for civialian jobs, so then they are stuck to languish in the military until they hit the 20 year mark, sucking down $140k a year as a burden to military medicine. Many at that point feel so uncomfortable with their lack of medical competency that they leave the medical profession altogether. You may think I am exagerrating, but in my field literally each base has a senior 0-5 or O-6 doc that fits that category. It is unbelievable that people could get to the point where they would throw away all the dreams, hard work and training required to become a physician for a paltry government pension.

So am I bitter? Not really because I was the one who signed my life away--I can only blame myself. Do I regret the decision every day I wake up in the morning? Yes. Would I sign up for the military again? Not a chance.

I share these things with you who may be on the fence trying to decide. The worst part is that there is no way to reverse your decision once you sign up--no matter how much your circumstances, perspectives or needs of your family change over the years. So basically I am dealing every day (and for the next 10 years) with the consequences of a decision I made as an impoverished undergraduate student, never having practiced a day of medicine in my life (or even having entered med school, for that matter). So for those of you ready to sign up, please weigh all of these things very carefully--because there is no looking back once you give your final answer.

 

[Fiend]

Pike Med,
Don't do it. Also, if you pass on a 4th year scholarship, it is doubtful they will consider you for a 3-year scholarship.
I know folks who were ten times as excited as you to join the AF and ended up miserable.
From what you describe, you will be a terrible match for the AF or any branch of the military.