Regret withdrawing my acceptance

[Melvillei]

I recently withdrew my acceptance from USUHS after choosing to attend a civilian USMD program instead. I just couldn't overlook the ≥7 year obligation plus the many cons of milmed discussed on these boards: lack of control over my career and family life, limited job opportunities for my SO, fewer residency spots making otherwise accessible specialties harder to match into (e.g. PM&R, EM), bureaucratic burden sucking time away from clinical practice, low case volume/acuity leading to skill rot, etc.

Even with all that in mind, I still kind of regret my decision. I've wanted to serve for a long time now and it feels like I've just closed the door on that path in life. I guess I could still apply to the 3 year HPSP program at this point, but I've received a scholarship at the civilian school that would somewhat reduce the financial value of HPSP.

Is it still worth going for it simply based on a desire to serve? Or did I make the rational decision by forgoing the military entirely?

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[DMBandFan86]

I think you read the forum well and understand the cons of military medicine. Overall these forums are generally negative, but that doesn’t mean that is everyone’s experience.

If you still want to serve, why would the doors be closed? Still many opportunities. The biggest thing to decide is do you want a civilian residency or a military residency? You could apply for HPSP and still do military service. You can wait until residency and do FAP. You can join after residency and incentives will be available. You can also consider reserves. You have lots of options and opportunities.

If you want to do PM&R in the military then you likely won’t be able to get a position afterwards. Unless something changes, there are 0 available Army active duty or reserve positions and it is not critical. I think the only way to get that position is via military residency or getting really lucky. If you decide you want to join the military during residency or after and be active duty, then you really want to be in a critical specialty.

 

[armytrainingsir]

Guard or Reserves after you finish residency if you still need to scratch the itch.

 

[TheEarDoc]

Get your training then do the Guard or Reserves. Get a huge sign on bonus. Get the rest of any loans paid for. Control your own destiny better and get less chance of getting the green weenie!

 

[AttackDog]

As long as you are a physician in good standing and don’t partake in recreational drug use, the opportunity will always be there.

Look into the Financial Assistance Program during residency. With your scholarship you can maximize your ability to choose your specialty and financial opportunity while still being able to serve.

That said, if you cannot stomach bureaucracy, beware.

 

[mudderMD]

I joined the guard when I became an attending. I don't owe them anything and qualified for a hefty sign on bonus. You can still serve without all of the strings attached.

 

[j4pac]

The guard/reserves is an underrated way to serve

 

[DMBandFan86]

The guard/reserves is an underrated way to serve

I thought you were PM&R? Getting a job as a physician assistant in the army after completing residency isn’t underrated to me. They don’t even let you do field surgeon anymore if you have a non-critical specialty. Sure they are basically similar jobs, but a crappy way to make a doc do 6 month deployments instead of 3 and be stuck in role 1 or 2.

If this poster is going to do EM then military can be a good job. I would stay away from the reserves if wanting to do PM&R.

 

[j4pac]

I thought you were PM&R? Getting a job as a physician assistant in the army after completing residency isn’t underrated to me. They don’t even let you do field surgeon anymore if you have a non-critical specialty. Sure they are basically similar jobs, but a crappy way to make a doc do 6 month deployments instead of 3 and be stuck in role 1 or 2.

If this poster is going to do EM then military can be a good job. I would stay away from the reserves if wanting to do PM&R.

I’m not in the service any longer. But I do know lots of reservist/guard physicians who haven’t regretted their decision. I guess everyone’s experience is different. I think it’s a viable option when comparing to HPSP.

 

[navdoc47]

joining the Reserves is dumb from a financial compensation perspective. if you do 20 years of active duty, all your chronic ailments slowly build towards your VA claim (100% is $3500/month tax free plus more if you have dependents). you basically are doubling your military retirement pension.

whereas in the Reserves, all your chronic ailments will do nothing towards your VA claim (since not military connected while a reservist), so your VA claim is likely to be a lot less. plus the fact that you can't start collecting your pension until age 59.

There's a reason why reserve docs are promoted on time nearly 100% - there aren't enough suckers to go around.

 

[DMBandFan86]

You’re not considering salary difference in civilian world, can be 2x+ than active duty military. Do that for 20 years and who cares about possible VA benefits. Doctors don’t join the reserves for the money, it’s to experience the military but still keep their civilian careers.

 

[armytrainingsir]

joining the Reserves is dumb from a financial compensation perspective. if you do 20 years of active duty, all your chronic ailments slowly build towards your VA claim (100% is $3500/month tax free plus more if you have dependents). you basically are doubling your military retirement pension.

whereas in the Reserves, all your chronic ailments will do nothing towards your VA claim (since not military connected while a reservist), so your VA claim is likely to be a lot less. plus the fact that you can't start collecting your pension until age 59.

There's a reason why reserve docs are promoted on time nearly 100% - there aren't enough suckers to go around.

It really depends.

Former HPSP and I left AD with 10 years. And zero retirement benefits to show for that decade other than the 2k per year I put in a Roth as an attending.

Joined the reserves later in life, knocked out the other 10.

Only did one deployment and my employer cut a check when I got back to make up the difference between my salary and mil pay.

When I hit 60 in a bit, $3600/mo gross and no significant health insurance costs or worries for me or my younger wife.

To match that on the civilian only side, I would have needed to put back an extra 700+k.

YMMV.

 

[ProwlerturnGas]

It really depends.

Former HPSP and I left AD with 10 years. And zero retirement benefits to show for that decade other than the 2k per year I put in a Roth as an attending.

Joined the reserves later in life, knocked out the other 10.

Only did one deployment and my employer cut a check when I got back to make up the difference between my salary and mil pay.

When I hit 60 in a bit, $3600/mo gross and no significant health insurance costs or worries for me or my younger wife.

To match that on the civilian only side, I would have needed to put back an extra 700+k.

YMMV.

This. Almost my exact situation and I hit 20 this year. Looking at it from my current perspective it was a wise move.

Edit for clarity

 

[TheEarDoc]

joining the Reserves is dumb from a financial compensation perspective. if you do 20 years of active duty, all your chronic ailments slowly build towards your VA claim (100% is $3500/month tax free plus more if you have dependents). you basically are doubling your military retirement pension.

whereas in the Reserves, all your chronic ailments will do nothing towards your VA claim (since not military connected while a reservist), so your VA claim is likely to be a lot less. plus the fact that you can't start collecting your pension until age 59.

There's a reason why reserve docs are promoted on time nearly 100% - there aren't enough suckers to go around.

They must have lost that memo because the promotions have been #$%& lately!

As for the service connection, yes it is BS that in active duty every ache and pain can be turned in for compensation even when people are doing dumb $%&* like getting hurt playing flag football, but in the reserves unless it happens on duty (and often times unless you get an LOD or good buddy statement) you aren't getting service connection for it.

I see a lot of guard/reservists though play the disability game when they go on active duty for a mob or deployment and they claim every ache and pain during or at the end of it and then they take the disability pay every single month while serving in the guard/reserves until they hit 20 or decide to leave. They just subtract your drill pay from your disability pay, but often times these folks are 50-90% service connected and still serving and doing drill each month on top of the disability tax free.