Reasons for HPSP vs USU?

[Asclepius293]

Hey all,

Down to the wire in my decision making between Navy HPSP at Thomas Jefferson in Philadelphia or Navy at USU. Anyone here that made a similar decision and has some insight?

USU
Pros:
-O-1 salary during med school, zero cost of attendance, cool travel opportunities, camaraderie, better prepared for military med/better connections, possibly a leg up in applying for in-house military residencies?
Cons:
-7 year payback offers less flexibility (especially if you aren't getting what you want due to the needs of the Navy and need to GMO and GTFO)

HPSP at Jefferson
Pros:
-tuition covered, diverse exposure to civilian medicine as well as limited military med exposure with ADTs, more flexibility with 4 year commitment to GMO and GTFO if needed for specialty of choice, loved the school itself and the vibe. Center City, Philadelphia is awesome.
Cons:
-Might end up owing +4 years anyways if I land a military residency after GMO in which case I would have been better off financially having picked USU.

Specialty wise I find general surgery, dermatology, and infectious diseases interesting. I know that will probably change with exposure over the next few years.

Anyone make a similar decision and have some insight or see additional points I'm missing? Combed through the mil med forums but figured I'd make my own post in case of additional thoughts. Thanks!

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[LePepe]

I mean, if you do USUHS you're pretty much gonna be career military.

4 years in school + 3 years in residency + 7 year payback = 14 years minimum in military

At that point, it's kind of hard to not just do 6 more years and then retire.

 

[Cooperd0g]

Option 3: take loans for school and do FAP once you get the civilian residency you end up wanting, if you still want to be in the military at that time.

 

[MusicDOc124]

It's hard to know if you want to make something a career without being in yet. I thought I'd make the military a career, and I've seen gotten out and gone to med school. Things change.

I'd look at competitiveness of the fields you want now/are currently open to, look at what percentage of them are new grads or did a GMO. I know for one of the branches, all derm positions were filled with prior GMOs i think last year or year before - don't have data from other years available to me at the moment.

Also consider location. Where would you be happier? Both places seem great, but each city (and rotation sites) will give you a different experience.

 

[pgg]

I mean, if you do USUHS you're pretty much gonna be career military.

4 years in school + 3 years in residency + 7 year payback = 14 years minimum in military

At that point, it's kind of hard to not just do 6 more years and then retire.

Not quite right - the USU years don't count toward retirement eligibility. You'd still need 10 more.

4 years in school + 3 years in residency + 7 year payback = 10 years toward retirement

Getting out at 10 may still be a good financial decision, depending on a number of factors.

USU years count toward the retirement multiplier, however. 20 years after you graduate you can retire with 2.5 x 24 = 60% of base high-3 instead of 50%.

At least, if you enter before 2018, when the new retirement scheme becomes mandatory.

 

[Asclepius293]

Thanks for the feedback all. I'm leaning towards HPSP for the added flexibility in case I need it. I've considered FAP but my reasoning for HPSP is that FAP isn't always available for certain specialties, isn't worth as much financially, and in some cases, difficult residencies like derm might actually become more available following a GMO tour vs applying civilian match out of med school.

 

[Mace1370]

Question - why do you want to join the military?

 

[Asclepius293]

Question - why do you want to join the military?

From a large military family and always wanted to serve. This way I can combine that with my aspiration to practice medicine. Also think I would benefit from and enjoy working with a military population for a time, travel opportunities, some unique experiences I wouldn't get otherwise. Spoke with one former flight surgeon that is now in residency at Stanford following 4 years as a gmo. He posed it as, at the end of my career, would I regret not having those 4 years in the military with the chance to do all that entails, or would I regret not having an additional 4 years to perhaps specialize sooner and make more money. Also, I've done some stuff in international health and think I might want to do foreign service/WHO one day. I think the military might be beneficial in that aspect. I've spoken to numerous physicians from different branches and definitely understand that you can get shafted sometimes if things don't work out. So I'm kind of leaning towards HPSP for the 4 year initial commitment vs 7 for the added flexibility in case (when) my aspirations change during school. How has your experience been so far? Would you have done FAP, HPSP, USUHS instead if you could go back? Thanks and appreciate the insight.

 

[Homunculus]

From a large military family and always wanted to serve. This way I can combine that with my aspiration to practice medicine. Also think I would benefit from and enjoy working with a military population for a time, travel opportunities, some unique experiences I wouldn't get otherwise. Spoke with one former flight surgeon that is now in residency at Stanford following 4 years as a gmo. He posed it as, at the end of my career, would I regret not having those 4 years in the military with the chance to do all that entails, or would I regret not having an additional 4 years to perhaps specialize sooner and make more money. Also, I've done some stuff in international health and think I might want to do foreign service/WHO one day. I think the military might be beneficial in that aspect. I've spoken to numerous physicians from different branches and definitely understand that you can get shafted sometimes if things don't work out. So I'm kind of leaning towards HPSP for the 4 year initial commitment vs 7 for the added flexibility in case (when) my aspirations change during school. How has your experience been so far? Would you have done FAP, HPSP, USUHS instead if you could go back? Thanks and appreciate the insight.

this is good info. I don't say this often, but if this is an itch you have to scratch, and you go in with your eyes open knowing you may end up doing 4 years of something you may not like and involve being away from your family for 9+ months (deployment and NTC), it could be a good fit. you'll definitely get some unique experiences, and will be a truckload of less debt when you get out. I'm not sure how much military service will help with WHO though-- I don't have any experience with that but the military (though relied upon heavily in some humanitarian missions) tends to be looked at leeringly by NGOs.

do you have a spouse? are they professionally employed? that's another thing to consider. if you are single, kudos (I married too early and divorced in residency) that's less to worry about currently but may factor in when you are paying off your ADSO.

in your particular case I would definitely suggest HPSP over USUHS. if you have other aspirations or desires USUHS will force you to put those off for a much longer time during your most productive years.

I had HPSP at a civilian school as a done deal, and I cancelled my USUHS interview. I'm thankful I did so. not because USUHS is a bad school but because it locks you in for 10 years. (3 years + 7 payback; more for longer residencies). 3 years may not seem like much but when you get there trust me it will be. it mainly give you options-- and with the new blended retirement system when you leave you'll have more than that flight surgeon had when they left. and if you decide to stay-- that's 3 years of extra bonuses you can sign up for that USUHS folks or people under obligation can't get.

and-- if you like ID or primary care, you may want to stay in for salary reasons. gen surg and derm you'd probably want to get out. less ADSO = more control = more options.

--your friendly neighborhood yes, I just said HPSP could be good for someone caveman

 

[DatInterviewDood]

I had HPSP at a civilian school as a done deal, and I cancelled my USUHS interview.

Did you leave after 4 years of service? and did you have a GMO tour?

 

[Homunculus]

Did you leave after 4 years of service? and did you have a GMO tour?

I was ROTC+HPSP. short version is I did ROTC, I took HPSP prior to 9/11 after talking to several docs and hearing how it was all homesteading, free CME and roses. obviously that changed. I did my 8 yrs for ROTC and HPSP but subspecialized because I liked subspecialty care better and the lifestyle of a subspecialist vs primary care in the .mil is significant.

still glad I didn't go the USUHS route or I'd be staring a forced career in the face-- like some of my USMA + USUHS colleagues. I feel for them. imagine starting medical school being an indentured servant for the next 15 years. ugh.

--your friendly neighborhood nearing his escape from the fiefdom caveman

 

[Mace1370]

From a large military family and always wanted to serve. This way I can combine that with my aspiration to practice medicine. Also think I would benefit from and enjoy working with a military population for a time, travel opportunities, some unique experiences I wouldn't get otherwise. Spoke with one former flight surgeon that is now in residency at Stanford following 4 years as a gmo. He posed it as, at the end of my career, would I regret not having those 4 years in the military with the chance to do all that entails, or would I regret not having an additional 4 years to perhaps specialize sooner and make more money. Also, I've done some stuff in international health and think I might want to do foreign service/WHO one day. I think the military might be beneficial in that aspect. I've spoken to numerous physicians from different branches and definitely understand that you can get shafted sometimes if things don't work out. So I'm kind of leaning towards HPSP for the 4 year initial commitment vs 7 for the added flexibility in case (when) my aspirations change during school. How has your experience been so far? Would you have done FAP, HPSP, USUHS instead if you could go back? Thanks and appreciate the insight.

It sounds like you actually want to join the military for the right reasons, which is great.

I think for you the choice comes down to how much time you want to spend staying in, how much you value your flexibility, and what your impression of the two schools are.

Something else to consider, in addition to the many excellent points discussed above, is fellowships. When you are initially considering USUHS vs HPSP you are thinking 7 years vs. 4 years. However, most people want to do all their training and be done with it. Doing a fellowship with the military will add more training, so that could be a potential downside you should think about. If you are truly ok with either deferring specialization until after your time with the military or adding time to your commitment + potentially limiting fellowship choices (not all fellowships are available in the .mil) then you can at least make that choice with eyes wide open.

 

[CitizenQ]

I did HPSP because I came from a military family and had an itch to scratch. My ADSO will be up soon, and I will be separating. I don't regret my choice based on what I knew, but I would not make the same choice today. The BS factor in the Army is bad and getting worse every day. From what I know from my Navy colleagues, it's worse there. (I do not know many Navy folks so take that line with a grain of salt.) The extra pay is not worth the complete lack of freedom to make any choices. I think it's gotten worse than it was 10-20 years ago based on stories from my mentors.

I'll add this fact. Traditionally, the military seeks to keep 25% of its MC officers through O-6 (this is widely discussed when they changed pay structures as part of DOPMA decades ago). Today, I can only think of one of my O-4 counterparts who might stay in to 20. 25% retention will not happen. All of us joined for the right reasons and were/are willing to make sacrifices but none of us enjoy the daily nonsense. I didn't mind deploying for nine months, but I hate the constant taskings to places like NTC, GS staffing issues, "accountability," idiotic productivity measurements, neverending training, and poor leadership, among other problems. There is no stability and it's not worth it.

 

[MaximusD]

Easy: HPSP and Jefferson.

 

[Perrotfish]

The financial difference between HPSP and USUHS is a rounding error in the grand scheme of medical salaries. If you love the military, going the HPSP route won't hold you back. If you hate the military, USUHS will trap you. Keep your options open.

 

[theonlytycrane]

I did HPSP because I came from a military family and had an itch to scratch. My ADSO will be up soon, and I will be separating. I don't regret my choice based on what I knew, but I would not make the same choice today. The BS factor in the Army is bad and getting worse every day. From what I know from my Navy colleagues, it's worse there. (I do not know many Navy folks so take that line with a grain of salt.) The extra pay is not worth the complete lack of freedom to make any choices. I think it's gotten worse than it was 10-20 years ago based on stories from my mentors.

I'll add this fact. Traditionally, the military seeks to keep 25% of its MC officers through O-6 (this is widely discussed when they changed pay structures as part of DOPMA decades ago). Today, I can only think of one of my O-4 counterparts who might stay in to 20. 25% retention will not happen. All of us joined for the right reasons and were/are willing to make sacrifices but none of us enjoy the daily nonsense. I didn't mind deploying for nine months, but I hate the constant taskings to places like NTC, GS staffing issues, "accountability," idiotic productivity measurements, neverending training, and poor leadership, among other problems. There is no stability and it's not worth it.

Would you do HPSP again if you had the choice?

 

[True Believer]

Would you do HPSP again if you had the choice?

I don't regret my choice based on what I knew, but I would not make the same choice today.

 

[Asclepius293]

So update. I was just offered a full ride scholarship to Wayne State. I may do that instead because then I still have no debt, more choice in my residency, and then can join afterwards if I still want to do the Navy through direct accession. Any thoughts?

 

[Gastrapathy]

Congrats. Take it.

 

[theonlytycrane]

@CitizenQ did you end up doing a GMO tour?

 

[Homunculus]

Congrats. Take it.

this^10

--your friendly neighborhood don't think twice about it caveman

 

[Cooperd0g]

Yes, definitely take that.

 

[Asclepius293]

My only reason for debate is that jefferson seemed slightly better experience/fun/education wise. But i guess it might make more sense to do free school in state then aim for residency out of state somewhere cool.

 

[Asclepius293]

@WernickeDO , @pgg any thoughts? Ha.

 

[SurgDoc95]

So update. I was just offered a full ride scholarship to Wayne State. I may do that instead because then I still have no debt, more choice in my residency, and then can join afterwards if I still want to do the Navy through direct accession. Any thoughts?

If you can handle Detroit go for it! Personally, I'd rather do HPSP than live/go to school in that city.

 

[Asclepius293]

If you can handle Detroit go for it! Personally, I'd rather do HPSP than live/go to school in that city.

Haha I grew up here and went to Wayne for undergrad. Its really not as bad as people make it out to be/how its portrayed.

 

[SurgDoc95]

Haha I grew up here and went to Wayne for undergrad. Its really not as bad as people make it out to be/how its portrayed.

I spent a summer doing research at the med school a few summers ago and it just wasn't my cup of tea. Congrats thats a helluva scholarship!

 

[pgg]

@WernickeDO , @pgg any thoughts? Ha.

You were offered a full ride to a US allopathic medical school? Take it, no question. And congrats.

 

[Cooperd0g]

No debate dude, I would take a full ride at a state school over HPSP or loans at Harvard, Hopkins, Stanford, UW, etc all day, every day.

 

[WernickeDO]

@WernickeDO , @pgg any thoughts? Ha.

Accepted to a fine school without the specter of hundreds of thousands of dollars of debt or surrendering control of your career to the military? You hit the jackpot, my friend. Congrats and don't look back.

 

[Red Lobster Actual]

Congrats OP!

Man a full ride scholarship. The two stories of full ride scholarships I heard of was that one guy who was on the MIT blackjack counting team that was made into a movie and a decorated Navy SEAL where one of his missions was...made into a movie...

Dude, what did you do??? Are we going to see a movie about your life?

 

[Asclepius293]

Congrats OP!

Man a full ride scholarship. The two stories of full ride scholarships I heard of was that one guy who was on the MIT blackjack counting team that was made into a movie and a decorated Navy SEAL where one of his missions was...made into a movie...

Dude, what did you do??? Are we going to see a movie about your life?

Haha thanks man! I ended up going with the full ride at Wayne. Somewhat bummed because I enjoyed Jeff and Philadelphia, but no loans or military commitment upfront should be worth a lot in freedom once I get to residency Thanks all for your feedback. I appreciate it.