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Recession and Military Medicine Retention

Discussion in 'Military Medicine' started by The White Coat Investor, Dec 2, 2008.

  1. The White Coat Investor

    The White Coat Investor AKA ActiveDutyMD
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    It appears that the military in general, and particularly the enlisted corps, are re-enlisting at record numbers due, at least in part, to the state of the economy. Are there any physicians who are considering this a factor in their decision to punch out or stay? Are there any prospective HPSP/USUHS folks who are considering this in weighing their decision to sign up for military medicine?
     
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  3. DrMetal

    DrMetal To shred or not shred?
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    Yes, indeed. I'm currently applying to USUHS, and it's the only program I applied to. I'm a little ahead in the game of life, with two dependents, a mortgage etc. So I could really use that AD paycheck, during school and residency. I can't go the civilian route, b/c it would mean putting my wife and kids through some financially brutal times, could possibly lose my house etc. That's how I came to this decision. . . . there are several others in my boat.

    USUHS rec'd a record number of applicants this year, from what I hear. I've also heard that the HPSP numbers are up, but I haven't seen an actual report.

    yeah, the economy always affects military retention. back in 1995-2000, everyone was getting out, retention is low. in this decade, the pendulum has swung the other way.

    you're an ED doc right? just outta curiosity, what's an ED doc make in the civi world?
     
  4. Galo

    Galo Senior Member
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    I talked to an army medical recruiter the other day. They were all at this park for an outing, and I very briefly told him I was an ex-military phycisian, and that their job must be difficult. He said they had signed up 297 out of 300. I don't know if that means that they only had 297 applicants and took them all, or what.

    Also, I think you are mistaken, or misinformed. Retention of military phycisians is at an all time low, especially in surgical subspecialties where they are in critically low manning numbers.

    Like its been said over and over, doing this for the money is the worst reason, though I can see how in your situation you may may think that is your best option.
     
  5. DrMetal

    DrMetal To shred or not shred?
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    they probably only had 297 applicants . . .I don't see why they'd leave 3 spots unfilled. So in other words, there's not much competition to get an hpsp spot. That agrees with what I've heard in the past . . . that if you've been accepted into a program, the military will almost always take you into hpsp. Now, I don't what the case was, say 20 years ago. Were HPSP spots ever heavily contested for???

    i don't doubt that retention is low for surg subspecs, as well as certain medical ones. for instance, i have aspirations to become a card. I know my civi counterpart will be making much more than me. But, the immediate financial comfort & convenience that my family will enjoy while I'm a USUHS student (hopefully!) and then in training, is much more important than the end-point salary. Plus with my prior service, I'll enjoy a slightly higher salary, and be able to finish my 20 in a sooner timeframe. Also, the retirement pension that I would gain (at say, an O-6 w/25 years) might bring me closer to my civilian counterparts when i join them. (i did the spreadsheet)

    anyway, aside from money matters (and it's good that we're discussing this, money does matter, especially as you get older and acquire dependents!!) . . . I do want to serve in the military. I enjoyed it back then and want back in, after being a civi for 5 years. . . come hell or high water.
     
  6. IgD

    IgD The Lorax
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    After you graduate USUHS, you will likely be required to complete a 2-3 year GMO tour. After you finish your medicine residency, you will have to complete another 2-3 year utilization tour before you can start the fellowship. Will you be able to complete all that before your retirement age?

    4 years USUHS
    1 year internship
    2 years GMO
    2 year medicine residency
    3 year utilization tour
    2 year cardiology fellowship

    That's a 14 year commitment not including the payback you would owe at the end.
     
    #5 IgD, Dec 2, 2008
    Last edited: Dec 2, 2008
  7. HackFuJones

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    I think what this recession shows is that the 401k experiment of buy it and hold for long term really isnt as great as its propped up to be, and that the military pension plan especially since it includes health insurance is worth quite a bit more than we might give it credit for.

    From reading some of the economic journals and listening to some of the experts, investing long term can be just as much of a crap shoot as day trading these days given that we've experienced 3 recessions in less than 20 years, crippling people that were close to retirement, and making investing a boom/bust situation which never is good for long term investing/planning.

    Does this mean that you should stay in the military for the retirement, no, but it might mean a 2nd look if you are not unhappy in your work environment and are not in a real high dollar specialty

    The real question I ask myself is can i save roughly 2-3mil(roughly the worth of a military pension with health benefits in civilian dollars) in 8-10 years. I say 8-10 and not 20 because Im already committed to the military for 10-12 years, so when you are doing the math, u need to look at it from that perspective unless of course you are a student who hasnt yet committed. The answer to my situation is that Im not sure, especially in this economy and the future of investing as whole.

    Anyway, I guess this and other recessions of recent years that people tend to forget about makes me at least do a double take on my retirement plans and future with the military.
     
  8. DrMetal

    DrMetal To shred or not shred?
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    Yeah, i did the math like this:


    1 year internship
    2 years GMO (at the conclusion, will have 5 years to pay back)
    2 year medicine residency
    3 year utilization tour (at the conclusion, will have have 2 year to pay back)
    3 year cardiology fellowship (say in military, FTIS)
    3 year card utilization tour (at conclusion, payback finished)
    --------
    = 14 years
    + 6 years (active duty prior service)
    --------
    = 20 years
    + 4 years at USUHS
    ---------
    = 24 years total service. (i think this agrees with your assessment, i just added the usuhs years last)

    As far as money goes . . . I made a spreadsheet, comparing civi and milmed tracks for me. Of course some assumptions went into it (i.e. for a Civi card i used an average salary of $300K, private med school etc) . . .Over the time period described above, I calculated that a civi card would come out on top (med school loans and all), by about +$600K.

    Now, I could join my civi card counterpart at age 50, and have about a $125K retirment (using a calc. that takes into account a 3-4% pay increase every year, assuming retiring as an O-6, etc). So I could erase that 600K delta in about 6-7 years. Then enjoy that retirement for the rest of my life!

    Anyway, the numbers work out for me, albeit there's a lot of assumptions. I encourage everyone to do an analysis like this.

    But again . . . .I also want to serve . . . that's the most important thing.
     
    #7 DrMetal, Dec 2, 2008
    Last edited: Feb 6, 2009
  9. IgD

    IgD The Lorax
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    I admire your enthusiasm but I think its a mistake to try to plan out your whole life like that. Things change drastically. Do you have a backup plan?
     
  10. Two-Bit

    Two-Bit New Member
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    you may want to assume retirement as an 0-5 if the timeline you put out is correct or at least adjust your retirement so your 'High 3' factors in that you may only be an O-6 for one or two of the last three years of service.
    The difference in O-6 and O-5 retirement is significant.

    This will make the difference in your comparison even more drastic.

    Granted promotion rates, time in zones, etc, may change in the future...
     
  11. The White Coat Investor

    The White Coat Investor AKA ActiveDutyMD
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    A military EP makes about $120-130K/year during his first tour. A civilian EP makes $260-300 these days.

    I don't know anyone board certified in EM who cannot get a job. It is fairly recession proof.
     
  12. DrMetal

    DrMetal To shred or not shred?
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    all true . . .hell there' no guarantee that I'll make O-5 even.

    yeah, there's a lot of assumptions that go into any type of life-long career planning . . .like the assumption that you'll be happy, your family will be happy . . .things can definitely change. I do have several backup plans. For starters, I haven't even gotten into USUHS yet, still applying. If I don't get in, I'm probaby going into biomedical research instead (Im a PhD). If I do get in and go the milmed route, I could change my mind, i may like IM a lot and just stick with that . . . or maybe I'll do an out-of-service fellowship . . yeah a lot can change, I'm mindful of that.
     
  13. notdeadyet

    notdeadyet Still in California
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    Asking Plan B is a pretty common interview question, but if you hear it in UHUHS, I'd probably not share yours. If you indicate that if you don't get in to a particular medical school, you'd abandon medicine all together might indicate a lack of passion for medicine, which can be fatal for career changers. Just a thought.
     
  14. DrMetal

    DrMetal To shred or not shred?
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    True, but what if the question is posed as, "what would you do if you couldn't get into any med school . . .if you just couldn't become an MD, what else would you do?" (I think that's the answer they're looking for.

    If the answer is "I'd cumble up and die", then that shows too much tunnel vision and unstable thinking. I've tried to demonstrate that I'm passionate about a few things (medicine, biomed. research, military) . . . so if one thing doesn't work out for whatever reason, I can pursue another passion and help the world in that context. It's good to be multi-dimensional . . .

    anyway we'll see how it goes, thanks for the input . . .
     
  15. notdeadyet

    notdeadyet Still in California
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    I agree. This is a common question too and I think your Plan B fits in nicely there. I'd just avoid mentioning that you're only applying to one school and a rejection would end a budding medical career. Just my $0.02.
     

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