payback time

[njaqua]

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So I understand that if you do a 5 year residency payback is only 4 years still. However, what if you do 6 years (e.g. 3 IM and 3 fellowship). Is your payback 5 years or 6 years? You don't "lose" the "free" year do you?

 

[IgD]

There are a couple of important considerations. First, you may be required to completed a 1-3 year general medical officer tour between internship and residency. Secondly, after you graduate medicine residency you might be required to complete another 1-3 year "utilization tour" prior to starting fellowship. So regardless of the amount of time you own on paper you might end up spending more time in the military than you anticipated.

 

[colbgw02]

Four key points to remember. If you keep these in mind, you should be able to synthesize your obligation for any scenario.

1) Internship (PGY-1) neither adds to nor fulfills any obligation.

2) Technically, you start paying back your obligation (from HPSP/USUHS/ROTC/USMA/Other) the day after you complete internship as long as you are on active duty.

3) Each year of active duty residency training beginning with the PGY-2 year incurs an additional year of obligation.

4) The obligation for fellowship is 6 months for 6 months, with a minimum obligation of 2 years.

It sounds circular, but trust me. Follow these rules and you'll get it right.

 

[met19]

Four key points to remember. If you keep these in mind, you should be able to synthesize your obligation for any scenario.

1) Internship (PGY-1) neither adds to nor fulfills any obligation.

2) Technically, you start paying back your obligation (from HPSP/USUHS/ROTC/USMA/Other) the day after you complete internship as long as you are on active duty.

3) Each year of active duty residency training beginning with the PGY-2 year incurs an additional year of obligation.

4) The obligation for fellowship is 6 months for 6 months, with a minimum obligation of 2 years.

It sounds circular, but trust me. Follow these rules and you'll get it right.

you forgot to mention that residency and med school or res and fellowhsip can be paid back concurrently. E.g. you owe 2 for med school, 3 for residency. You owe 3 years. Unless you already paid med school back by doing a GMO.

 

[colbgw02]

you forgot to mention that residency and med school or res and fellowhsip can be paid back concurrently. E.g. you owe 2 for med school, 3 for residency. You owe 3 years. Unless you already paid med school back by doing a GMO.

You are technically incorrect, and it's the reason you had to provide a caveat regarding GMO tours. This is covered by point number #2. If you follow my rules (which is how they are written), then there is no reason to provide that apparent "exception".

I would use your example to explain it, but the minimum HPSP obligation is 3 years. So there is no way to owe 2 years for medical school unless you had specially negotiated the contract.

 

[met19]

You are technically incorrect, and it's the reason you had to provide a caveat regarding GMO tours. This is covered by point number #2. If you follow my rules (which is how they are written), then there is no reason to provide that apparent "exception".

I would use your example to explain it, but the minimum HPSP obligation is 3 years. So there is no way to owe 2 years for medical school unless you had specially negotiated the contract.

Fine substitute 3 and 4 years rather than 2 and 3. But the point still stands.

The reason I made the point was your rule #3. Yes you accrue more time for residency. However, the point I was trying to make is that HPSPers can pay off time concurrently. The system is not completely additive (e.g. school plus residency).

Few examples:

HPSP 1: owes 4 years for school, does internship, does 2 year GMO, now owes only 2 years (since he/she paid back 2 as a GMO). Does an EM residency which is 2-4. Now owes total of an additional 3 years since residency time owed is longer than remaining school term. Will payback total of 5 years as result.

HPSP 2: owes 4 years, does straight thru IM residency: Owes only 4 years since school is greater than residency.

HPSP 3: owes 4 years, does internship, then GMO for 4 years, and gets out.

HPSP 4: owes 4 years, does internship, GMO for 4 years to get coveted residency in ortho (so school term is paid back), does ortho 2-5. now owes 4 years for residency. total payback 8 years.

Moral of the story: any education that the military contributes to leads to payback time. Time is paid back as either a GMO or attending.

 

[colbgw02]

I do not believe that you are technically paying back time concurrently. It only appears that way because some obligation is paid back while on an active duty residency. For most of us, the numbers work out the same.

Anyone want to break the tie?

 

[sethco]

HPSP 1: owes 4 years for school, does internship, does 2 year GMO, now owes only 2 years (since he/she paid back 2 as a GMO). Does an EM residency which is 2-4. Now owes total of an additional 3 years since residency time owed is longer than remaining school term. Will payback total of 5 years as result.

This only applies if you do a military residency after doing a GMO tour. In the above example, with a 4 year obligation from HPSP. If a person does a 2 year GMO tour, then enters a 3/4 year civilian residency, they only only 2 years after getting out of residency. However, if they do a military residency post-GMO tour then your apllication of the rule applies.

 

[cavaor]

I noticed that someone indicated intern year doesnt count for or against you. That depends on the situation. I only did HPSP for 2 yrs, so technically had a 2 yr obligation. As soon as I started my intern yr, my obligation became 3 years as the minimum payback is 3 yr as colbgw mentioned.

 

[NavyFP]

I noticed that someone indicated intern year doesnt count for or against you. That depends on the situation. I only did HPSP for 2 yrs, so technically had a 2 yr obligation. As soon as I started my intern yr, my obligation became 3 years as the minimum payback is 3 yr as colbgw mentioned.

That would be part of the minimum service obligation and intern year (if done in uniform) does count towards that time. You could then complete a 2 year residency (FM, Peds, IM) straight through and not incur additional time in service.

 

[met19]

This only applies if you do a military residency after doing a GMO tour. In the above example, with a 4 year obligation from HPSP. If a person does a 2 year GMO tour, then enters a 3/4 year civilian residency, they only only 2 years after getting out of residency. However, if they do a military residency post-GMO tour then your apllication of the rule applies.

i was only discussing military residencies. Options if people want civilian residencies: they either get deferral or payback all their time and get out.

 

[colbgw02]

I noticed that someone indicated intern year doesnt count for or against you. That depends on the situation. I only did HPSP for 2 yrs, so technically had a 2 yr obligation. As soon as I started my intern yr, my obligation became 3 years as the minimum payback is 3 yr as colbgw mentioned.

I have no doubt that you served at least 3 years, but I think that the reason why you did is because even a 2 year HPSP still results in a 3 year ADO. Not because intern year played any part. Again, I suppose one could always specifically negotiate this in their contract.