The Final Decision(AF HPSP)

[fizzle_22]

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Okay. I know I have posted here before, but this is my last time asking for advice and I really want the honest good bad and ugly. So my HPSP application has been submitted and my recruiter has told me to start looking into who I would want to do my commissioning so I am really trying to make my decision on whether I would accept the scholarship or not. I am interested in either EM or Peds(Though of course that is subject to change). I am a young black female if anybody can speak on the racial/sexual relations between milmed staff. No kids right now and never really planned to have any at a young age anyway. I always had an interest in the military but growing up with a part of my family that is religiously against serving I was kinda conditioned to think that military=front line war and dying(dramatic). I am actually excited with the idea of getting deployed even if that means I won't get to really do my specific job. I am really just open to opportunity and feel that life hands you s*** regardless and that I can make the best of it if I actually do it for the right reasons. So milmed physicians, HPSP students, anybody give me your input.

 

[pgg]

If you're excited about serving and have a basic understanding of the typical career path and its variability, go for it.

Lots of honest good bad and ugly experiences posted here. But we can't choose for you.

 

[WernickeDO]

The desire to serve has to be your #1 motivation. You may match to your #1 choice and have 8 great years, may go career, may go GMO and GTFO. All that is variable. But if you don't have a deep seeded desire to SERVE, then you will never be as satisfied as those that do.

The military is a microcosm of this country. I don't know the numbers on male/female enrollment, or racial demographics for that matter, but as a black woman you will be a minority within a possible slight minority. Some of my black colleagues have told me that they have felt some racial tensions and/or been discriminated against, so you will not be immune from that ugliness. Even highly educated types can harbor hate in their hearts. That is a risk that you take in the military, but I imagine you take that risk almost anywhere. As the whitest dude who ever lived I don't think I'm qualified to speak to that.

I usually tell premeds that if becoming a board certified physician is your goal, then stay away from the military. Only join if your desire to serve trumps your career goals.

 

[fizzle_22]

1) racism/sexism: Basically, don't worry about it. I haven't heard anyone complain about either for physicians in the military. We have all heard stories of sexism affecting other service members, particularly the warfighting enlisted, but Physicians are very insulated from that kind of thing.

2) Children: If you do want them, I think that the military (after residency) might be the most maternity friendly enviornment in medicine. 3 months of light duty before they're born and 3 months of leave afterwards. My civilian friends generally need to use their vacation to get 6 weeks of paid maternity leave.

3) EM/Peds: These are, unfortunately, the two specialties that are the hardest to get in the military in the civilian world. Both turn away qualified applicants who would have matched if they stayed civilian. If you do get your specialty of choice your post-residency EM experience will likely be miserable. Military ED doctors deploy frequently, and when they are actually home they usually don't see enough serious pathology to keep up their skills so the need to moonlight just to remain hirable. Peds is usually a better post residency experience, assuming you like outpatient Peds with nursery call, though for some reason we have decided not to use our own Pediatricians as hospitalists (which if insane).

Out of curiosity, how much will your medical school cost you per year?

Over 60k factoring in housing


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[kittridge1141]

1) racism/sexism: Basically, don't worry about it. I haven't heard anyone complain about either for physicians in the military. We have all heard stories of sexism affecting other service members, particularly the warfighting enlisted, but Physicians are very insulated from that kind of thing.

2) Children: If you do want them, I think that the military (after residency) might be the most maternity friendly enviornment in medicine. 3 months of light duty before they're born and 3 months of leave afterwards. My civilian friends generally need to use their vacation to get 6 weeks of paid maternity leave.

3) EM/Peds: These are, unfortunately, the two specialties that are the hardest to get in the military in the civilian world. Both turn away qualified applicants who would have matched if they stayed civilian. If you do get your specialty of choice your post-residency EM experience will likely be miserable. Military ED doctors deploy frequently, and when they are actually home they usually don't see enough serious pathology to keep up their skills so the need to moonlight just to remain hirable. Peds is usually a better post residency experience, assuming you like outpatient Peds with nursery call, though for some reason we have decided not to use our own Pediatricians as hospitalists (which if insane).

Out of curiosity, how much will your medical school cost you per year?

what do you mean when you say it's the hardest specialty to get in the military in the civilain world? I am also thinking of HSTP and EM but I thought you can go to whichever medical school/residency program of your choice? Does AF have residency programs on its own? As HSTP recipient, are you limited to those residency programs?

 

[kittridge1141]

The desire to serve has to be your #1 motivation. You may match to your #1 choice and have 8 great years, may go career, may go GMO and GTFO. All that is variable. But if you don't have a deep seeded desire to SERVE, then you will never be as satisfied as those that do.

The military is a microcosm of this country. I don't know the numbers on male/female enrollment, or racial demographics for that matter, but as a black woman you will be a minority within a possible slight minority. Some of my black colleagues have told me that they have felt some racial tensions and/or been discriminated against, so you will not be immune from that ugliness. Even highly educated types can harbor hate in their hearts. That is a risk that you take in the military, but I imagine you take that risk almost anywhere. As the whitest dude who ever lived I don't think I'm qualified to speak to that.

I usually tell premeds that if becoming a board certified physician is your goal, then stay away from the military. Only join if your desire to serve trumps your career goals.

As an AF doctor, are you not board certified?

 

[Perrotfish]

what do you mean when you say it's the hardest specialty to get in the military in the civilain world? I am also thinking of HSTP and EM but I thought you can go to whichever medical school/residency program of your choice? Does AF have residency programs on its own? As HSTP recipient, are you limited to those residency programs?

All military services have their own residency programs, and when you join through HPSP you are obligated to do their match unless they let you out of it (which they rarely do). The match works just like the civilian match, but the odds of getting any given specialty with a given class rank/step 1 score are different. Some are pretty similar to the civilian world, like Ortho. Some are somewhat easier to get than in the civilian world, like Derm. Some are significantly harder, like Peds and EM. And some residencies don't exist at all in the military, like PM&R and IM/Peds.

They can't force you to accept a residency you don't want, and if you don't get the residency you want you have the option to say no and serve out your obligation as a GMO (a general practitioner for active duty) but it is very possible for them to deny you a Residency you would have gotten through the civilian match.

That being said 60K/year -> Peds is a tough road in the civilian world as well.

 

[Helpful Troll]

.

 

[WernickeDO]

As an AF doctor, are you not board certified?

Not if you only do an internship. If you are considering milmed take a look at the stickies and use the search function in this forum for general questions.

 

[kittridge1141]

All military services have their own residency programs, and when you join through HPSP you are obligated to do their match unless they let you out of it (which they rarely do). The match works just like the civilian match, but the odds of getting any given specialty with a given class rank/step 1 score are different. Some are pretty similar to the civilian world, like Ortho. Some are somewhat easier to get than in the civilian world, like Derm. Some are significantly harder, like Peds and EM. And some residencies don't exist at all in the military, like PM&R and IM/Peds.

They can't force you to accept a residency you don't want, and if you don't get the residency you want you have the option to say no and serve out your obligation as a GMO (a general practitioner for active duty civilians) but it is very possible for them to deny you a Residency you would have gotten through the civilian match.

That being said 60K/year -> Peds is a tough road in the civilian world as well.

Thanks for your response! it was so helpful. So as a HPSP recipient, I have to apply to military residency but I can also apply to civilian residency. If I get accepted at civilian EM residency program but not military EM residency program, do I have to become a GMO instead of accepting civilian EM residency program?

How long do I serve as a flight surgeon if I become a GMO instead of residency program?

 

[Perrotfish]

Thanks for your response! it was so helpful. So as a HPSP recipient, I have to apply to military residency but I can also apply to civilian residency. If I get accepted at civilian EM residency program but not military EM residency program, do I have to become a GMO instead of accepting civilian EM residency program?

How long do I serve as a flight surgeon if I become a GMO instead of residency program?

Not exactly. If you are AF HPSP you apply for the military match. Which is in December. The civilian match is in March. If you want to be allowed to apply to the civilian match you have to apply for a deferment in the military match. If they don't give you a deferment you'll never have the opportunity to be accepted to a civilian EM residency because you'll never get to apply. If you do get the deferment then you go through the match in March.

If you apply to the military match you rank you top 5 choices, so your choices would likely be:
1) Defer
2) AF ED Program #1
3) AF ED program #2
4) AF ED program #3
5) Transitional year.

If you get the transitional year then you basically have to become a GMO when you finish. That's 2-3 years. In the Navy it's routine to come back to residency after a 2 year GMO tour. My understanding is that in the AF its much more common to serve out 4 years as a flight surgeon and then apply for civilian residencies after you finish your obligation, but I'm not sure about that. Your obligation for HPSP is 4 years after Intern year, if you choose to serve it out.

 

[kittridge1141]

Not exactly. If you are AF HPSP you apply for the military match. Which is in December. The civilian match is in March. If you want to be allowed to apply to the civilian match you have to apply for a deferment in the military match. If they don't give you a deferment you'll never have the opportunity to be accepted to a civilian EM residency because you'll never get to apply. If you do get the deferment then you go through the match in March.

If you apply to the military match you rank you top 5 choices, so your choices would likely be:
1) Defer
2) AF ED Program #1
3) AF ED program #2
4) AF ED program #3
5) Transitional year.

If you get the transitional year then you basically have to become a GMO when you finish. That's 2-3 years. In the Navy it's routine to come back to residency after a 2 year GMO tour. My understanding is that in the AF its much more common to serve out 4 years as a flight surgeon and then apply for civilian residencies after you finish your obligation, but I'm not sure about that. Your obligation for HPSP is 4 years after Intern year, if you choose to serve it out.

Ah I see. If I do AF ED residency, would I still get the opportunity to be a flight surgeon?
Also how competetive is AF HPSP? I am not a citizen yet so I would probably have to wait till next year and apply for 3 year scholarship. My GPA and MCAT scores are both above requirement. I remember reading that would mean automatic acceptance but having also read how competetive AF HPSP is, I am a bit confused.

Again, thank you for your insight!

 

[Perrotfish]

Ah I see. If I do AF ED residency, would I still get the opportunity to be a flight surgeon?
Also how competetive is AF HPSP? I am not a citizen yet so I would probably have to wait till next year and apply for 3 year scholarship. My GPA and MCAT scores are both above requirement. I remember reading that would mean automatic acceptance but having also read how competetive AF HPSP is, I am a bit confused.

Again, thank you for your insight!

If you want to be a flight surgeon then you do an Intern year, become a flight surgeon, and then go back to be an ED doctor. Once you finish ED training they will use you as an ED doctor. More importantly, once you finish ED training you only want to be used as an ED doctor. Medical knowledge fades really fast when you're not using it, and that's particularly true right out of training when you haven't had the chance to solidify your knowledge through repetition. When you finish residency you want to plunge into the highest volume, highest acuity job you can and then maybe ease off at a later time.

The 4 and 3 year scholarships are different levels of competitive. The 3 year scholarship does not, in fact, exist every year, and the competitiveness varies wildly depending on how many they need. The 4 year scholarship will usually most people who are motivated and meet the GPA cutoff.

If you really want to spend 2-3 years as a GMO, BTW, I would recommend the Navy. They're much more set up for people to transition into a short GMO tour after intern year and then back into residency. They also get a lot more cockpit time as part of flight surgery training.

 

[kittridge1141]

If you want to be a flight surgeon then you do an Intern year, become a flight surgeon, and then go back to be an ED doctor. Once you finish ED training they will use you as an ED doctor. More importantly, once you finish ED training you only want to be used as an ED doctor. Medical knowledge fades really fast when you're not using it, and that's particularly true right out of training when you haven't had the chance to solidify your knowledge through repetition. When you finish residency you want to plunge into the highest volume, highest acuity job you can and then maybe ease off at a later time.

The 4 and 3 year scholarships are different levels of competitive. The 3 year scholarship does not, in fact, exist every year, and the competitiveness varies wildly depending on how many they need. The 4 year scholarship will usually most people who are motivated and meet the GPA cutoff.

If you really want to spend 2-3 years as a GMO, BTW, I would recommend the Navy. They're much more set up for people to transition into a short GMO tour after intern year and then back into residency. They also get a lot more cockpit time as part of flight surgery training.

I expect to get my citizenship at the very latest May of next year. I would start school in August. Would that be too late to apply for 4 year scholarship?

 

[Perrotfish]

I expect to get my citizenship at the very latest May of next year. I would start school in August. Would that be too late to apply for 4 year scholarship?

No idea. These are the kind of questions recruiters can actually help with, though.

 

[kittridge1141]

No idea. These are the kind of questions recruiters can actually help with, though.

Got it. Thank you again for everything!

 

[narcusprince]

1) racism/sexism: Basically, don't worry about it. I haven't heard anyone complain about either for physicians in the military. We have all heard stories of sexism affecting other service members, particularly the warfighting enlisted, but Physicians are very insulated from that kind of thing.

2) Children: If you do want them, I think that the military (after residency) might be the most maternity friendly enviornment in medicine. 3 months of light duty before they're born and 3 months of leave afterwards. My civilian friends generally need to use their vacation to get 6 weeks of paid maternity leave.

3) EM/Peds: These are, unfortunately, the two specialties that are the hardest to get in the military vs in the civilian world. Both turn away qualified applicants who would have matched if they stayed civilian. If you do get your specialty of choice your post-residency EM experience will likely be miserable. Military ED doctors deploy frequently, and when they are actually home they usually don't see enough serious pathology to keep up their skills so the need to moonlight just to remain hirable. Peds is usually a better post residency experience, assuming you like outpatient Peds with nursery call, though for some reason we have decided not to use our own Pediatricians as hospitalists (which if insane).

Out of curiosity, how much will your medical school cost you per year?

Thanks Perrotfish for your white male entitled answer.
1) Racism and sexism do exist. And they are abundant in military medicine. Racism and sexism ranges from unwavering favor of support. In our fields something invariably goes wrong you make a wrong diagnosis, or patient non-compliance, or pick whatever no win situation you have. Your white male colleagues will be seen as the standard and you the outcast. They might give each other the support and leave you out to pasture. Even if you are just as skilled or more skilled then them you will be viewed differently in the military because you are different then the norm. I have seen colleagues get away with serious sexist infractions that would have gotten folks on the outside fired. We are not insulated from racial and sexism in the military.

 

[fizzle_22]

So I was selected for the AFHPSP. Just trying to tie up some last minute details just for clarification not necessarily to decide whether I'll take it.

1) In the residency match, one could possibly receive none of the options on their top 5 choices?

2) Would you guys recommend civilian deferred programs as a first choice in EM/Peds?

3) In the case that I am not able to go straight into residency, I would be a flight surgeon and serve my 4 years AD?

4) Does serving as a flight surgeon help when it's time to match into an EM residency later on in the military(should I decide to stay in) or in the civilian match?

 

[WernickeDO]

So I was selected for the AFHPSP. Just trying to tie up some last minute details just for clarification not necessarily to decide whether I'll take it.

1) In the residency match, one could possibly receive none of the options on their top 5 choices?

2) Would you guys recommend civilian deferred programs as a first choice in EM/Peds?

3) In the case that I am not able to go straight into residency, I would be a flight surgeon and serve my 4 years AD?

4) Does serving as a flight surgeon help when it's time to match into an EM residency later on in the military(should I decide to stay in) or in the civilian match?

1) yes that is a possibility
2) I don't believe the military has an Em/peds program so that is likely your only option
3) if you do your time and get out you will do a transitional yeast followed by gmo/fs time.
4) whether or not a fs tour helps in the military is a point of debate. It will help you in the civilian match. If your goa is to become a board certified physican then avoid the military.

So I was selected for the AFHPSP. Just trying to tie up some last minute details just for clarification not necessarily to decide whether I'll take it.

1) In the residency match, one could possibly receive none of the options on their top 5 choices?

2) Would you guys recommend civilian deferred programs as a first choice in EM/Peds?

3) In the case that I am not able to go straight into residency, I would be a flight surgeon and serve my 4 years AD?

4) Does serving as a flight surgeon help when it's time to match into an EM residency later on in the military(should I decide to stay in) or in the civilian match?

 

[fizzle_22]

1) yes that is a possibility
2) I don't believe the military has an Em/peds program so that is likely your only option
3) if you do your time and get out you will do a transitional yeast followed by gmo/fs time.
4) whether or not a fs tour helps in the military is a point of debate. It will help you in the civilian match. If your goa is to become a board certified physican then avoid the military.

sorry for the confusion. By EM/Peds I meant EM or Peds. I am interested in both and haven't decided which I want to go in.
And for clarification to your answer to #3 i would finish medical school, for an internship year and then 4 years of GMO?

 

[WernickeDO]

sorry for the confusion. By EM/Peds I meant EM or Peds. I am interested in both and haven't decided which I want to go in.
And for clarification to your answer to #3 i would finish medical school, for an internship year and then 4 years of GMO?

Yes that is correct. If you want to do em or peds your best bet is to not join the military as both of these specialties are highly competitive.