I have been speaking with the Commander who deals with internships (Robyn Treadwell, you can google her exact title),
Why don't you just tell us what her title and position is?
🙂
and she is saying that an HPSP grad can almost always choose their own specialty (like if it’s very competitive, maybe you won’t get that first choice). If you don’t get in first try, you do a year on a team (it sounded like she was describing GMO, but bc I’m super unfamiliar with this stuff, I’m not sure).
It's always been true that in the end, the great majority of HPSP/USUHS grads do match into their first choice specialty. Sometimes with an intervening GMO tour.
The same is true of the civilian match (minus GMO time, obviously).
However, while these statements are factually true, they lack a bit of context. The elephant in the room is self-selection and how these applicants decide what their "first choice" actually is. Medical students are smart people who can do math, and they generally don't apply to specialties they know they can't match to.
Some of this calculus relates to their grades and board scores, and some of this calculus relates to the system they're applying within. For the HPSP'ers, there are considerations like historical stats, the (relatively few) number of spots, whether a specialty even exists in the military GME system, and whether or not the military health system projects a need to train a particular specialist in any given year.
In the military, some of those things are clear to anyone who looks and some are more opaque.
If you want to be a general surgeon or psychiatrist or anesthesiologist, you can count on the Navy having a number of residency positions for those every year. If you want to be a pediatric endocrinologist or do an adult cardiothoracic fellowship after your anesthesiology residency ... well, the Navy doesn't really need a lot of those, and sometimes years will go by when there are ZERO people who are selected for training.
So, did a would-be cardiac anesthesiologist who had to wait 7 years for an ACTA fellowship slot to be approved by the GME selection board get his "first choice" ... technically yes. If he didn't apply for the years when the GMESB offered zero slots, does that mean he didn't want to?
Self selection is the caveat behind every rosy "almost everyone gets what they want" proclamation.
Her words were something like “without being board certified, you can’t practice” saying that an untrained doctor is essentially useless in the Navy.
This is a bizarre statement given the continued extensive use of GMOs, who are by definition not board certified (or board eligible), and arguably untrained.
Tonight I talked with a Navy surgeon who did HPSH ten yrs ago. He said 100% you do not choose your specialty. He said before residency, everyone must do a GMO for 2-3 yrs. He said don’t bother asking my recruiter bc they know nothing.
Recruiters don't know anything, true. They aren't doctors. They're not usually acting in bad faith or lying, but they believe the brochure they've been given. They are uninformed, and they work in a high pressure number-driven arena that rewards them for signups. Buyer beware.
Not everyone does GMO tours. Straight-through training is a thing, has always been a thing, and has become a more common thing in the last 10-20 years. How common now? Depends very much on specialty. Some specialties send most or all of their interns straight on to PGY-2 and residency, some specialties send few of them straight through.
So I’m looking for any advice or feedback on what I should actually expect. I’m not a DO candidate. I am a competitive MD applicant with a high gpa and my MPH will be complete next year. I’m only interested in psychiatry. I’m totally fine with the Navy owning me for at least 4 years, but I am attached to choosing my specialty. I’m also not sure I like the idea of a GMO, as a nontrad student, I don’t want to start residency in my 40s.
The good news is that the military will not force you into a specialty you don't want. Worst case, you do an intern year, serve out your 4 year obligation as a GMO, then go to the civilian match and start residency in the field you want (assuming you match of course). Part of that worst case is that it's possible you'll end up in a prelim intern program that isn't a good fit for the residency you want to do. If you want to do psychiatry, there's a nonzero chance they'll send you to do a surgery internship. If you want to be a surgeon, there's a nonzero chance they'll send you to do an internal medicine internship. These outcomes are
unlikely given that you're a competitive applicant with a high gpa and I wouldn't lose any sleep over them.
More likely in this era, is that you'll apply to the specialty you want (psychiatry), match, train straight through, and then do a 4 years as a psychiatrist in the Navy before deciding to get out, or stay in for a longer period.
I don't know how competitive psychiatry is at the Navy programs these days, but my feeling is that your odds are quite good.
Disclaimer - I retired from the Navy in 2022 and every day that goes by my information gets a little more out of date.
