I am currently applying to medical school and hoping to be accepted into the AF HPSP. However, because I have a wife and 1.5 children, I'd like to be careful about making large decisions for the family, especially after hearing repeatedly that the military dictates your residency, location, etc. Since I hope to do primary care, going to medical school and supporting a family without a stipend and debt forgiveness seems nigh impossible.
After reading about a thousand of the HPSP threads, I've realized that they tend to attract a level of cynicism and/or aggrieved military physicians. I am hoping to hear some unheard positive HPSP experiences here. Also, current helpful statistics/factoids (positive or negative) would be welcome.
commhealth
i think the reason this forum (which doesn't really have anything else like it out there) tends to be the way you interpret it as is because of both selection bias and reality. yes, people tend to be more vocal when they are complaining. but the absence of positive rebuttals should tell you that 1) that no one with positive things to say has the courage or desire to post it on an anonymous forum (not likely but maybe i suppose) or 2) that the points being brought up don't really have a positive counter argument. just look at how many recruiters have come in and been chewed up/spit out and their bones ground up into bread. many of the negatives are a matter of personal opinion and viewpoint. what may be painful and miserable to one may be tolerable for the outcome for another. but the bottom line is most of the complaints/issues are fact.
i don't want to rehash my entire career, but i am squarely in the "not sure wtf i am going to do" when i hit my first ADSO at 14 years. the mere fact that i am on the fence about it at 14 should give you pause, but i can explain a bit further.
first, i am ROTC+HPSP. and i had to sub specialize so i wouldn't gouge my eyeballs out in primary care. hence my obligation. that being said, HPSP and high interest title loans are similar-- you sign up for the quick fix, and don't really think out the long term consequences. you can't sign up for something at 22 and really know what you will be wanting at 30. people mature, priorities change, spouses and kids come along, and you start to wonder why you were so scared of the same debt that people all around you took on without pause.
moving doesn't sound like a big deal. until you've done it every 3 years, and start to see how much stress is involved in buying or renting, moving, and finding yourself not really wanting to put down roots anywhere since you'll just be moving again anyway. kid's school? spouses job? same deal.
ok, so as long as you know that's the deal, that's doable, right? surely there's some predictability to this, you say? you would think. see, the line officers talk about "career maps" and "planning your 20 year career" but the fact of the matter is in the medical corps it's a total crapshoot. not only could they move you to a position not even in your medical field (flight surgery, brigade surgeon) you may also be told to move simply due to some admin guy deciding you've been someplace too long. so any "map" you may come up with will be worth about the paper you scribbled it down on. air force included.
now, in exchange for this, yes-- "debt free" so to speak. if you are a primary care specialty you will see about half the patients for about the same pay. subspecialist or surgery you'll make less, but also see substantially less. patient volumes per provider in the military pale in comparison to civilians. so in a way i don't get too wrapped up around the axle about pay-- i get wrapped around the axle about the admin BS.
for me personally, i am dual military which has it's own hurdles and issues which don't apply to you. but, i have been fortunate to be able to buy a property in DC that is appreciating beyond what we ever expected it would, and bought a home in our current duty station that will hopefully be a nice rental for the long term as well. i've transferred by GI bill (so has my spouse) so getting out at 14 would leave us with 2 nice properties we could sell or rent, a good chunk in our TSPs, transferred GI benefits, and a decent resumé when i get out to likely have a choice of several better compensated civilian jobs.
the retirement cheese is nice. and to be honest, i would be totally fine retiring as an O-5 if i am left alone. but what has become increasingly painful is something that really hit home when i went to a retirement last spring. this individuals career was as a clinician, and they did well, retired, the typical thing. but then when they spoke they mentioned the sacrifices that their now college aged kids had to make during their childhood for the army. it occurred to me that when i signed up for HPSP i didn't realize that i would also be signing up my kids for HPSP-- and i don't think most people do. or if they do, i don't think it really hits home like it does when you are staring a deployment or operational tour or random PCS move in the face. or being on service and tied to the hospital unable to travel for months at a time because your department is understaffed. or any number of other things that are unique to military life.
i can't and won't tell anyone to carte blanche sign up for HPSP. you need to go into it for "more than the money" and you need to have a full understanding of what it is like having no control over your career. if you can accept that, and that you are firmly established as "human capital" and essentially an employee like everyone else, you'll be fine. in fact, i think the 3 year HPSP may be the best deal. 75% debt free, but the kicker is that with only a 3 year commitment you are only looking at 1 duty station and you can GTFO. 4 years they can screw with you more. fellowships-- well, that's a whole other cost/benefit analysis.
the best stories i've heard and the happiest people i've met have been the hpsp civilian medschool, civilian residency who show up somewhere, do their time, then get out. it's almost like a bad dream that way i imagine. i've even seen a civilian medschool/residency/fellowship who did her time at a MEDCEN as a sub specialist then leveraged her military pay and admin setup to get a sweet academic gig. so there's some hay to be made out there if you can find it. the key is being your own advocate and knowing what you're getting into. which this forum, for better or worse, eliminates the excuse that this information isn't out there. google military medicine and this forum is there. we didn't have this resource back in the "old days"-- no that for some it really would have mattered.
at any rate, it's good you came to seek out advice, but the "positives" you are looking for may need to be asked more specifically. mainly it's money. "serving your country" is such a loaded term you don't really want me commenting on it. there are some good youtube videos of i think some privates sweeping and taking out garbage or something. yup, serving their country. lol. sounds noble but when you get behind the curtain the show loses some luster.
good luck
--your friendly neighborhood served my country keeping mandatory training up to date caveman
