Questions about AF Emergency medicine and HPSP in general

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

AF M4

Junior Member
10+ Year Member
15+ Year Member
Joined
Jul 6, 2006
Messages
884
Reaction score
6
Hi, I'm a 4th year medical student and I have a 3-year HPSP commitment. I'm interested in emergency medicine and was hoping that someone could help me out with some questions and concerns...

I'm currently doing an EM rotation at Wright-Pat and I've put together the following story from a couple of the first year EM residents here:

A few years ago, some guy decided that the AF ERs were overmanned and they only allowed 12 ER residency slots total (military only, no civilian deferments were offered) for all applicants. This created a significant backwash of candidates who were shunted into transitional years. The following year the AF offered more slots, but since there was now a bunch of docs still wanting to do EM coming off their transitional year, these guys were given priority over the graduating medical students and only 1 graduating medical student got an EM residency slot. The AF still hasn't released the number of EM slots to be offered this year, but from the above story I'm guessing that whatever it is, my chances of getting a spot aren't good. I think I'd do well if I were just going into civilian match (Step 1 -229, Step 2 - 258, good clinical scores) but it sounds like my qualifications aren't a decisive factor.

I've read a great deal of the posts on this board, and I really wish that I could email this forum's threads to myself back when I was considering the scholarship. Anyway, this year the Air Force has instituted a policy whereby all students who are put into a PGY1 transitional year because they didn't get matched are automatically assigned to a 2-year Flight Surgeon tour, to make up for a personnel shortfall. So this looks likely to be in my future. I would really appreciate someone answering questions about this service:

- the way I understood it, the PGY1 doesn't count towards my 3 years of service, but the years as a Flight Surgeon would. So could I simply say okay, I'll do 3 years as a Flight Surgeon and then my commitment would be over? What about reserve time? I want to do something for my country and I've met a lot of great people in the Air Force and I do enjoy helping them, but not at the expense of my career. If I don't get to do EM despite working my ass off for 4 years and doing well, I would not consider re-applying for an Air Force residency - I'd just figured once burned, twice shy and finish off my contract as a Flight Surgeon. Any comments would be greatly appreciated!

Members don't see this ad.
 
It can't hurt for you to apply the the EM spots, if you don't get it you are correct--you will go do your 1 year and then go into Flight surgery. If you do 3 years in FS, you will be finished with your active duty commitment--you will have a remaining commitment of 5 years in the IRR (note--this is non-drilling).

If you end up in FS, make the best of it--some locations will provide you with really good experiences. How many docs get to say they got to be checked off, and fly in an F-16?
 
I'm Navy, not AF.

AF M4 said:
it sounds like my qualifications aren't a decisive factor.
They aren't, if you're competing against PGY-1s or returning GMOs/Flight Surgeons. The point system is fairly rigid and heavily weighted toward them.

AF M4 said:
the way I understood it, the PGY1 doesn't count towards my 3 years of service, but the years as a Flight Surgeon would.
Correct.

AF M4 said:
So could I simply say okay, I'll do 3 years as a Flight Surgeon and then my commitment would be over?
Yes.

AF M4 said:
What about reserve time?
In theory, they could call you back. I don't believe this has happened to anyone as of yet. Those (Navy) GMOs I've known the last few years who've done their 3-4 years and headed to civilian residencies haven't been bothered, yet.

AF M4 said:
I want to do something for my country and I've met a lot of great people in the Air Force and I do enjoy helping them, but not at the expense of my career. If I don't get to do EM despite working my ass off for 4 years and doing well, I would not consider re-applying for an Air Force residency - I'd just figured once burned, twice shy and finish off my contract as a Flight Surgeon. Any comments would be greatly appreciated!
You could try applying for a deferment and do a civilian EM residency, then serve your obligation. Full deferments are, I believe, not easy to get.

The choice it seems you'll likely face is, no deferment granted and then
  • after internship + 2 years as a GMO, apply for an AF EM slot. Given your scores + GMO time, you'll probably get one. The 3 years of residency incur another 3 years of obligated service, to be served concurrently with the final year of your HPSP committment. So despite doing 2 years as a GMO, you'll still owe 3 years after residency. 5 years total payback + 4 years GME = 9 years in uniform after medical school.
  • or, after internship + 3 years as a GMO, get out and do a civilian residency.
Either way, you're doing at least 2 years as a flight surgeon. You're probably going to know whether or not you want to remain in the AF after the first 18 months, and you can decide then whether to apply for AF GME or do your time and get out.
 
Members don't see this ad :)
AF M4 said:
only 1 graduating medical student got an EM residency slot. QUOTE]

I am AF HPSP also interested in EM. Are you sure only 1 med student got an EM residency slot or did 1 med student get a military EM slot? A fourth year at my school got a civilian deferral for EM- she wanted a military slot but didn't get it. I think 24 EM slots were offered last year w/ about 50 applicants- and I believe about half were deferrals. I am sure the military slots went almost exclusively to transitional/ GMO applicants, but I am pretty sure several med students got deferrals. I am working with some folks at the surgeon generals office in DC this summer and according to the manpower office- it looks like EM slots will be plentiful for the next few years thanks to the war in Iraq. So don't give up yet!

Question: Does anyone know if GMOs can get selected for civilian deferral spots or are you only eligible for military residencies once you go on active duty (unless you wait until your commitment is up). Thanks!
 
I personally worked with the AF's Emergency medicine consultant to the surgeon general and she is one of the coldest, most heartless people I have ever met in my 40 year life. So... good luck.
 
dpill said:
AF M4 said:
only 1 graduating medical student got an EM residency slot. QUOTE]

I am AF HPSP also interested in EM. Are you sure only 1 med student got an EM residency slot or did 1 med student get a military EM slot? A fourth year at my school got a civilian deferral for EM- she wanted a military slot but didn't get it. I think 24 EM slots were offered last year w/ about 50 applicants- and I believe about half were deferrals. I am sure the military slots went almost exclusively to transitional/ GMO applicants, but I am pretty sure several med students got deferrals. I am working with some folks at the surgeon generals office in DC this summer and according to the manpower office- it looks like EM slots will be plentiful for the next few years thanks to the war in Iraq. So don't give up yet!

Question: Does anyone know if GMOs can get selected for civilian deferral spots or are you only eligible for military residencies once you go on active duty (unless you wait until your commitment is up). Thanks!

I am applying for a AF EM slot too. I spoke to an EM intern (now 2nd yr) at Wilford and rumor is that there will be no civillian deferments granted for the upcoming year with a total of ~12 spots (she might have said 16...) At any rate, a pretty horrible selection rate when you compare it to the 97% civilian match rate. The low number of spots is totally counterintuative bc like someone mentioned before, the need for EM docs is greater than ever. I guess we'll see what the real deal is when the forecast comes out. They are really taking their sweet time posting the results...

http://www.airforcemedicine.afms.mil/afphysicianeducation/
 
dpill said:
AF M4 said:
only 1 graduating medical student got an EM residency slot. QUOTE]

I am AF HPSP also interested in EM. Are you sure only 1 med student got an EM residency slot or did 1 med student get a military EM slot? A fourth year at my school got a civilian deferral for EM- she wanted a military slot but didn't get it. I think 24 EM slots were offered last year w/ about 50 applicants- and I believe about half were deferrals. I am sure the military slots went almost exclusively to transitional/ GMO applicants, but I am pretty sure several med students got deferrals. I am working with some folks at the surgeon generals office in DC this summer and according to the manpower office- it looks like EM slots will be plentiful for the next few years thanks to the war in Iraq. So don't give up yet!

Question: Does anyone know if GMOs can get selected for civilian deferral spots or are you only eligible for military residencies once you go on active duty (unless you wait until your commitment is up). Thanks!

GMO's can enter a re-deferred status to complete a civilian residency if selected by the JSGME, but it involves separation from active duty and then returning to active duty to complete the original HPSP ADSC. Re-deferred residents do not incur an additional ADSC for residency.
 
MeganRose said:
dpill said:
I am applying for a AF EM slot too. I spoke to an EM intern (now 2nd yr) at Wilford and rumor is that there will be no civillian deferments granted for the upcoming year with a total of ~12 spots (she might have said 16...) At any rate, a pretty horrible selection rate when you compare it to the 97% civilian match rate. The low number of spots is totally counterintuative bc like someone mentioned before, the need for EM docs is greater than ever. I guess we'll see what the real deal is when the forecast comes out. They are really taking their sweet time posting the results...

http://www.airforcemedicine.afms.mil/afphysicianeducation/

I hope that isn't true. Maybe that is part of their scheme to get more flight surgeons, since you're stuck doing a 2 yr GMO tour if you don't match. I wouldn't be surprised.
 
island doc said:
dpill said:
GMO's can enter a re-deferred status to complete a civilian residency if selected by the JSGME, but it involves separation from active duty and then returning to active duty to complete the original HPSP ADSC. Re-deferred residents do not incur an additional ADSC for residency.

Is it harder for active duty applicants to get a civilian deferral than med students (do they expect active duty to take the military spots first)? Thanks!
 
Yes, I have heard that some flight docs have great experiences. I'm just terrified of being stuck on an island somewhere with a group of seriously ill patients and only a transitional year's worth of training to guide me, since most of the attending flight surgeons have apparently packed up and left.
 
Top