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[SirGecko]

Even the navy is now trying to push you to complete your training before going out o practice independently. While there are probably always going to be opportunities to practice as a GMO in the military I am really not certain I can recommend this as a goal. You should want to practice medicine as a fully trained doctor. I was an intern trained UMO and while dive school is a lot of fun and I think I probably did an ok job at it I don’t think that intern only trained doctors should be asked to fill some of the roles that they are asked to fill in the GMO system.

That said going to the actual plan, don’t apply for a residency you don’t want to do. Unless something changes you can decline residency training if you choose to.

P.S. Just so you know it’s HPSP not HSPS

 

[Helpful Troll]

Hello, I’m in the process of applying to medical school this cycle. If I get in, and depending on the cost of the program, I’m seriously considering HPSP as a way to pay for school. For the specialities that I’m currently interested in (EM/Psych/Neuro), financially I think HPSP is still comparable to the loans route. But I would give it the edge because I don’t like the idea of swimming in debt for a decade. I also want to scratch this itch to serve my country for a period of time, though I don’t want to have a military career.

If I do go the HPSP route, I’m most heavily leaning towards Navy, with AF in second. I’m actually quite fascinated with the operational medicine jobs offered by these branches (FS/UMO/GMO). From what I’ve read, this seems like an amazing chance to do some cool things that I’ll probably never have a chance to again. Fly jets, dive, deploy in weird places around the world… yes please.

In terms of paying back my ADSO, I would strongly prefer the GMO+GTFO strategy that I’ve seen some people reference, as that way I can control where my residency happens, no delay into fellowship, and no potential skill atrophy afterwards by going back to ADSO.

This post is essentially asking, how can I basically make sure that GMO+GTFO will work as a plan? When I apply to military match, ideally I would want TY+GMO billet(s) until ADSO is done. Is this always an option? For instance, if I get a military match into a specialty after TY, can I decline it for a GMO instead? Alternatively if not, what if my strategy was trying to match into a super competitive specialty (such as neurosurg), knowing that I almost certainly wouldn’t get it, so that I would be “forced” to GMO? And then applying for my real specialty at the end of ADSO? Any other surefire plays/ideas would be greatly appreciated!

Thanks for the response! Can you elaborate on this point more? What percent of the work would you have felt more competent to do if you were residency vs. intern trained? I have seen a number of posts where people say many GMOs don’t even use/use very little of their specific training while out in operational land.
https://www.fastpeoplesearch.com/address/316-framingham-rd_marlborough-ma-01752
Obviously sending out a fully trained doctor to the fleet is preferable from the Navy’s perspective, but by training fully in the military, I would basically extend my obligation by 4 (to 6 years) if I do residency (+fellowship). And at that point, since I would be 4+1+4+2+6=17 years deep I might as well stay in for the remaining time to get 20 years. Which is the exact route I don’t want to do.

I think your 'years deep' is miscalculated but I may be misinterpreting your timeline. The first four years of med school on HPSP don't count for retirement as you are in the IRR when in med school... with the exception of a currently disputed option to 'earn' those years if you join the reserves after you leave active duty. Your residency time (1+4) is likely overstated based on your stated specialty preference unless you built in a research year or two.

In the military match you might be pushed to a civilian (lower pay) intern year/residency/fellowship which would lower your time on AD unless you are on active duty in civilian training which increases the payback period... Lot's of paths can knock you off the GMO and out option. There are no guarantees.

Get an acceptance to medical school then decide if you actually want to serve. Get into medical school and take out the loans.

 

[DOswag]

Hello, I’m in the process of applying to medical school this cycle. If I get in, and depending on the cost of the program, I’m seriously considering HPSP as a way to pay for school. For the specialities that I’m currently interested in (EM/Psych/Neuro), financially I think HPSP is still comparable to the loans route. But I would give it the edge because I don’t like the idea of swimming in debt for a decade. I also want to scratch this itch to serve my country for a period of time, though I don’t want to have a military career.

If I do go the HPSP route, I’m most heavily leaning towards Navy, with AF in second. I’m actually quite fascinated with the operational medicine jobs offered by these branches (FS/UMO/GMO). From what I’ve read, this seems like an amazing chance to do some cool things that I’ll probably never have a chance to again. Fly jets, dive, deploy in weird places around the world… yes please.

In terms of paying back my ADSO, I would strongly prefer the GMO+GTFO strategy that I’ve seen some people reference, as that way I can control where my residency happens, no delay into fellowship, and no potential skill atrophy afterwards by going back to ADSO.

This post is essentially asking, how can I basically make sure that GMO+GTFO will work as a plan? When I apply to military match, ideally I would want TY+GMO billet(s) until ADSO is done. Is this always an option? For instance, if I get a military match into a specialty after TY, can I decline it for a GMO instead? Alternatively if not, what if my strategy was trying to match into a super competitive specialty (such as neurosurg), knowing that I almost certainly wouldn’t get it, so that I would be “forced” to GMO? And then applying for my real specialty at the end of ADSO? Any other surefire plays/ideas would be greatly appreciated!

Active duty AF Psychiatrist here. Seems there's always some discussion about each branch doing away with the GMO/FS type billets but it never seems to actually happen in reality. Seems likely you'll be able to do an intern year, then GMO/FS, then GTFO as that doesn't seem to have slowed down over the years. I commissioned in 2010 and that was discussed on SDN even back then. I was thinking EM/FM at the time and also considering going FS, then GTFO, then residency training civilian. You never know what's going to happen in medical school and many (not sure the numbers exactly) end up changing their mind of specialty once they get into school/rotations. This could add some years on to your commitment if you go the HPSP route. I didn't match EM with the mil match my first round and got deferred civ transitional year. Fell in love with Psych that year and reapplied psychiatry and matched milmed psych but the residency program didn't acknowledge my intern year (a DO TRI) and had to start over intern year and complete 4 more years of training. I'm currently at 8 years active duty time and separating next month.

All that to say, get accepted into med school first. Be very careful to weigh the options before signing HPSP. I know loans sound daunting right now. But also signing a big chunk of your life to the military is a big commitment (and should be more daunting to naive premeds than it is). You'll make plenty of money to payback loans and there's several other payback options once you're out of residency. You can always join guard/reserves to scratch the itch later on. Hard to predict what's going to happen in the world between now and when you're done with school/intern year/residency as well which could impact your military career.

I wouldn't recommend trying to "play the system" so to speak and apply for something you don't want. That'd be too risky for me although yes, just playing the competitive odds it'd be difficult to match neurosurg straight out of school.