Questions regarding post-medical school/post-GMO consequences of HPSP scholarship

[FromKermitsHome]

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TL;DR: I'm considering the 3-year HPSP Navy scholarship. I have two important questions at the end.

Hey everyone, I’m currently an M1 at one of my state's MD schools, and I’ve been considering taking the 3-year HPSP scholarship, specifically with the US Navy. I’ve been going through the process along with a recruiter. INB4 you ask, the chances of me being approved for it are extremely high (I didn't have to do the board interview), so I’m thinking ahead before I accept anything.

I made some mistakes during the medical school application process. I have vowed to not do that again during medical school, especially while researching the HPSP program, the scholarship, the time in the military, and the infamous payback system.

So, I'm writing this out to have my current conceptions about the possible timelines possible with a 3 yr-HPSP scholarship either confirmed or corrected. Please correct me if I am wrong. So, here goes:

As I currently understand, there are 4 ways that my obligation to HPSP ends (from a 3-year scholarship):

1) GMO and out. I immediately do 3 years as a GMO after medical school. If I understand this correctly, I do not owe any payback as active duty after GMO, but I do owe 5 years in the reserve. I would prefer to be a flight surgeon.

2) Interrupted residency training – do 3 years GMO after intern year (at military residency. Civ doesn't allow interrupted training?). Please correct me if I'm wrong.

3) Straight through training – Finish residency (will most likely be civilian, with civilian pay so no accrued payback), and then do 3 years GMO. This is the least attractive option for me as I will most likely be married with kids at that point, no longer in my physical prime, and will also have skill atrophy. But I hear conflicting information, though.

4) New option – Comes from this post: New Navy Residency/GMO Program - Beware | Student Doctor Network. Apparently, I have a guaranteed residency spot if I decide to do an extra 1-2 years of training? That is also unattractive as it means that I have to accrue extra years onto training, but I’m open to it.

I'm only 21 years old, so I'm willing to bend to the "needs of the Navy" from the age of 25-28. But after that, no way. For that reason, I have my heart set on the GMO and out route. Other than quietly completing my reserve duties, I want little to do with the Navy afterwards. If I get somehow called from the reserves, then I take the L on the chin.

Other than that, I would highly prefer to match into a civilian residency after finishing my 3-year GMO service/tour.

I've gone through the financial repercussions of it, and since I won't be graduating with any debt, the service time is fine for me. I also don't plan on pursuing a military residency (unless it's a last-ditch effort for Ortho, ENT, Gen Surg, IM or EM), so if I decide to change my specialty, I'm fine with that. I currently don't have a single bit of interest in any "ROAD" specialties, but people say it could change? dunno 'bout that.

Thus, I have two questions:

1) Has anyone here (or know anyone who has) recently undergone the "GMO and out" -> civ. residency path, and successfully matched to a preferred/high-ranked civilian residency? If you have personal experience that would be great as well.
2) How does the reserves duty requirement look for a Navy GMO/FS/DMO? Is it doable with a surgical residency (not Neurosurg lol)?

Also, if anyone knows what path would lead to a better outcome for my residency applications (GMO and out - residency application vibes), some say that doing a straight through residency is better than doing GMO and out? Curious to hear people's opinions on it.

These are highly pertinent questions I ask because they can make or break my decision to sign up for the scholarship. I believe my judgement is somewhat clouded due to my inexperience. Please enlighten me.

 

[pgg]

TL;DR: I'm considering the 3-year HPSP Navy scholarship. I have two important questions at the end.

Hey everyone, I’m currently an M1 at one of my state's MD schools, and I’ve been considering taking the 3-year HPSP scholarship, specifically with the US Navy. I’ve been going through the process along with a recruiter. INB4 you ask, the chances of me being approved for it are extremely high (I didn't have to do the board interview), so I’m thinking ahead before I accept anything.

I made some mistakes during the medical school application process. I have vowed to not do that again during medical school, especially while researching the HPSP program, the scholarship, the time in the military, and the infamous payback system.

So, I'm writing this out to have my current conceptions about the possible timelines possible with a 3 yr-HPSP scholarship either confirmed or corrected. Please correct me if I am wrong. So, here goes:

As I currently understand, there are 4 ways that my obligation to HPSP ends (from a 3-year scholarship):

1) GMO and out. I immediately do 3 years as a GMO after medical school. If I understand this correctly, I do not owe any payback as active duty after GMO, but I do owe 5 years in the reserve. I would prefer to be a flight surgeon.

No. Immediately after medical school you will do an intern year. You will be required to apply for an intern year at military hospitals, but you can request civilian deferment for it. No guarantees. 100% must do an intern year first, then you can go on to residency or GMO time.

Intern year is payback neutral - it neither incurs additional obligation, nor fulfills any obligated service requirement.

2) Interrupted residency training – do 3 years GMO after intern year (at military residency. Civ doesn't allow interrupted training?). Please correct me if I'm wrong.

There are many single-year prelim internships out there.

3) Straight through training – Finish residency (will most likely be civilian, with civilian pay so no accrued payback), and then do 3 years GMO. This is the least attractive option for me as I will most likely be married with kids at that point, no longer in my physical prime, and will also have skill atrophy. But I hear conflicting information, though.

You would not do a GMO tour after completing civilian residency - nor would you want to. You would serve 3 years on active duty practicing in whatever specialty you trained in. With the caveat that the military caseload for some specialties is low or lacking in acuity, so those 3 years may inflict some skill atrophy. To some extent, in some locations, some specialties may have civilian moonlighting opportunities, where you can get cases and earn some extra money.

4) New option – Comes from this post: New Navy Residency/GMO Program - Beware | Student Doctor Network. Apparently, I have a guaranteed residency spot if I decide to do an extra 1-2 years of training? That is also unattractive as it means that I have to accrue extra years onto training, but I’m open to it.

I posted some thoughts in that thread. I would read it and give serious thought to the notion that in this era, GMO tours are not a good thing for the physician, most of the time.

I'm only 21 years old, so I'm willing to bend to the "needs of the Navy" from the age of 25-28. But after that, no way. For that reason, I have my heart set on the GMO and out route. Other than quietly completing my reserve duties, I want little to do with the Navy afterwards. If I get somehow called from the reserves, then I take the L on the chin.

Other than that, I would highly prefer to match into a civilian residency after finishing my 3-year GMO service/tour.

I've gone through the financial repercussions of it, and since I won't be graduating with any debt, the service time is fine for me. I also don't plan on pursuing a military residency (unless it's a last-ditch effort for Ortho, ENT, Gen Surg, IM or EM), so if I decide to change my specialty, I'm fine with that. I currently don't have a single bit of interest in any "ROAD" specialties, but people say it could change? dunno 'bout that.

Thus, I have two questions:

1) Has anyone here (or know anyone who has) recently undergone the "GMO and out" -> civ. residency path, and successfully matched to a preferred/high-ranked civilian residency? If you have personal experience that would be great as well.

GMO time is not likely to be a handicap, and is likely to be a benefit, when applying to civilian residencies. Even competitive ones. However - the other parts of your application matter more (grades, USMLE scores, references).

I would not count on military service and GMO time to compensate for an otherwise shaky application to competitive programs.

2) How does the reserves duty requirement look for a Navy GMO/FS/DMO? Is it doable with a surgical residency (not Neurosurg lol)?

I don't think I follow this question. There isn't a reserves requirement if you GMO & out. There's an IRR (inactive ready reserve) requirement that is inconsequential, involves no time, and will not impact civilan residency.

Also, if anyone knows what path would lead to a better outcome for my residency applications (GMO and out - residency application vibes), some say that doing a straight through residency is better than doing GMO and out? Curious to hear people's opinions on it.

These are highly pertinent questions I ask because they can make or break my decision to sign up for the scholarship. I believe my judgement is somewhat clouded due to my inexperience. Please enlighten me.

Straight through training is always desirable.

GMO tours are undesirable. Don't get me wrong - they can be enjoyable or rewarding, and they can be a non-handicap to other career/specialty aspirations if you don't mind the delay they cause. There are a lot of old threads here on the GMO phenomenon, and the great majority of us who've done them and are now residency-trained physicians are of the opinion that GMOs should not exist.


Without knowing anything else about you, I would advise completing medical school without HPSP (loans are fine! that's how the vast majority of medical students pay for school!), completing internship and residency, and then - if you still want to serve in the military - join as an attending. This guarantees straight-through training and avoids GMO time. And most importantly, it defers your decision on accepting a military obligation until the time you'd actually start serving it. A lot can change in the next 4 years - your outlook on life, your specialty aspirations, the presence/absence of a spouse or significant other, etc.

One of the big underappreciated risks of HPSP is that it demands a decision NOW for a commitment that won't start until YEARS into the future. Sometimes many years (approaching a decade!) if one is civilian-deferred for GME. That's a lot to ask of anyone.