Timeline of a future HPSP student

[halethsonofhama]

So I've read through alot of the threads here.... but I'm having trouble finding a time line of what I can expect.

I just got accepted to medical school and am looking into the Army HPSP to help with tuition and allow me to focus on school (not finances). I am also interested in the program because I have always felt that I have missed out by never serving my country, opting for college instead; this lets me do both. While I feel like this program may work for me, I don't want to get involved with something where I will not be appreciated and ultimatly come out of it in a bad position (not properly trained to work as a civilian Doc).

I want to walk through my understanding of this whole process and I hope you guys might be able to correct me if I'm wrong. I'll also scatter some questions throughout if anybody wants to answer them.

MED SCHOOL
I would be commissioned as a second lieutenant and attend a 6 week training course over the summer. I would then start M1 in august. (I have also heard it is possible to delay the 6 week training until the summer following M1). I would then proceed through M4 as any other med student. This seems wrong that I wouldn't have any contact with he military during this time.

RESIDENCY (an area of much confusion for me)
You will apply for your desired specialty and be matched in the army first. If there are no positions, then it is possible to appeal for a civilian residency. I have seen many people say that being assigned GMO/GME the year after med school is likely as not everybody will match. Why did these people not match (was it that they were just poor students? If it was limited military positions, why could they not apply for civilian residency?) My understanding of GMO/GME that this is just non-specialized doctoring. Does a year of GMO/GME count towards your owed active duty time or is it still considered part of the residency years? I do not want to be delayed in my career simply because there was no room for me in my specialty. I do not want to be forced doing non-specialized medicine when I could be advancing my career. Essentially, can I ensure getting my specialty smply by being a 'great' med student?
My intended specialty (which most likely change) is emergency medicine. I can only assume that the Army will properly train me, and utilize me as an ER Doc. Does anyone know if this specialty is hard or easy to match into in the military?

ACTIVE DUTY
Assuming ER residency between 3-5 years I will be required to pay back with 4 years of active duty. Here I realize they can send me wherever they please and deploy me. Other than the expected rigidity of a military life and the hassles of working in the military health system... it is pretty straight forward.
One concern is that I will most likely have a young family by this time; what can I and my wife expect for raising children? How do military wives usually react to military life (Something tells me it isn't like the TV show). She is training as a nurse; will she be able to find employment on base?

POST DUTY
While I am free to pursue a civilian career, I can still be called to active duty for the next four years should the need arrive. But unless that happens, I will have no military obligations.
It seems like finding a civilian position is easy enough with a military background. Is this the same for fellowships?
I'm assuming with the financial benefits of the HPSP program, and living frugally while on active duty, I will be financially stable to lead a comfortable life for me and my future family.

SUMMARY
4 Years med school >>> 3-5 years residency >>> 4 years active duty>>>continue or enter civilian

FINAL THOUGHTS
A lot of the stickies in this forum are back from 2006. Are these downfalls of military medicine still as prominent (or even worse) now? Has anything been done to fix the general complaints?

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[Charlie0318]

SUMMARY
4 Years med school >>> 3-5 years residency >>> 4 years active duty>>>continue or enter civilian

5 year residency you would owe 5 years active duty.

3-4 year residency owes 4 years active duty.

Also for Army HPSP it is rather difficult to get into Officer Basic the summer before MS1, for example if you are starting this fall, you would have had to be signed up for it already at this point to get it. The vast majority do it the summer between MS1 and MS2.

 

[haujun]

So I've read through alot of the threads here.... but I'm having trouble finding a time line of what I can expect.

I just got accepted to medical school and am looking into the Army HPSP to help with tuition and allow me to focus on school (not finances). I am also interested in the program because I have always felt that I have missed out by never serving my country, opting for college instead; this lets me do both. While I feel like this program may work for me, I don't want to get involved with something where I will not be appreciated and ultimatly come out of it in a bad position (not properly trained to work as a civilian Doc).

I want to walk through my understanding of this whole process and I hope you guys might be able to correct me if I'm wrong. I'll also scatter some questions throughout if anybody wants to answer them.

MED SCHOOL
I would be commissioned as a second lieutenant and attend a 6 week training course over the summer. I would then start M1 in august. (I have also heard it is possible to delay the 6 week training until the summer following M1). I would then proceed through M4 as any other med student. This seems wrong that I wouldn't have any contact with he military during this time.

RESIDENCY (an area of much confusion for me)
You will apply for your desired specialty and be matched in the army first. If there are no positions, then it is possible to appeal for a civilian residency. I have seen many people say that being assigned GMO/GME the year after med school is likely as not everybody will match. Why did these people not match (was it that they were just poor students? If it was limited military positions, why could they not apply for civilian residency?) My understanding of GMO/GME that this is just non-specialized doctoring. Does a year of GMO/GME count towards your owed active duty time or is it still considered part of the residency years? I do not want to be delayed in my career simply because there was no room for me in my specialty. I do not want to be forced doing non-specialized medicine when I could be advancing my career. Essentially, can I ensure getting my specialty smply by being a 'great' med student?
My intended specialty (which most likely change) is emergency medicine. I can only assume that the Army will properly train me, and utilize me as an ER Doc. Does anyone know if this specialty is hard or easy to match into in the military?

ACTIVE DUTY
Assuming ER residency between 3-5 years I will be required to pay back with 4 years of active duty. Here I realize they can send me wherever they please and deploy me. Other than the expected rigidity of a military life and the hassles of working in the military health system... it is pretty straight forward.
One concern is that I will most likely have a young family by this time; what can I and my wife expect for raising children? How do military wives usually react to military life (Something tells me it isn't like the TV show). She is training as a nurse; will she be able to find employment on base?

POST DUTY
While I am free to pursue a civilian career, I can still be called to active duty for the next four years should the need arrive. But unless that happens, I will have no military obligations.
It seems like finding a civilian position is easy enough with a military background. Is this the same for fellowships?
I'm assuming with the financial benefits of the HPSP program, and living frugally while on active duty, I will be financially stable to lead a comfortable life for me and my future family.

SUMMARY
4 Years med school >>> 3-5 years residency >>> 4 years active duty>>>continue or enter civilian

FINAL THOUGHTS
A lot of the stickies in this forum are back from 2006. Are these downfalls of military medicine still as prominent (or even worse) now? Has anything been done to fix the general complaints?

Please read the forum completely as your questions have been covered in the sticky etc and you want to conduct thorough research before signing away next 11 or more years to the military.

Outlook: There is another way serving your country than signing for HPSP now.

Medical School: OBC is generally taken between M1 and M2.

Residency: ER is competitive and may be more competitive than the civlian sector during particular year group. Selection to certain specialty (derm, rad, er, ortho, ob, physical rehab etc) vary year by year for the military and influenced by military points system. It is not just academics and being prior service carry some merits during residency/fellowship selection. Time spent during GMO count towards your obligation. Military will not force into any residency that you do not wish. People choose GMO for varied reasons such as unknown career plan, non-selection due to increased competition during particular year vs poor performance, personal reason, desire serve in OP environment etc.

Active duty: This depends greatly on your assignment. It is challenging for your wife to be employed while you serve in the military due to frequent PCS move and employment limitation at particular station. Also since you are signing away 11 years of your life it is difficult to prepare for this life now as a medical student. Really think about this and share the concerns with your wife as her life will be affected by this.

Post duty: Most military physicians ( and fellowship trained) move on to civilian sector without any issues at end of ADSO.

 

[halethsonofhama]

Please read the forum completely as your questions have been covered in the sticky etc and you want to conduct thorough research before signing away next 11 or more years to the military.

Outlook: There is another way serving your country than signing for HPSP now.

Residency: ER is competitive and may be more competitive than the civlian sector during particular year group.

I did read (spent a few good hours...) its just that Its hard to shift through through and pick out the actual information from the misinformation. I just wanted to make sure my understanding was correct.

As for the competitiveness of EM in the military. If I cannot match into a military residency, then I assume I would be in the pool for civilian residencies..... so technically wouldn't my chances "improve" since I am now considered for 2 pools (more application spots)?

Or do they just advertise the possibility for a Civilian residency but they don't actually allow for it.... essentially forcing people to do GMO's?

 

[halethsonofhama]

5 year residency you would owe 5 years active duty.

3-4 year residency owes 4 years active duty.

I'm confused, so you are saying PGY-1 through PGY-5 would make me owe 5 years instead of 4?

I thought they allow for "years they paid for" + 1 extra year without adding on additional active duty years.

 

[Easy C]

As for the competitiveness of EM in the military. If I cannot match into a military residency, then I assume I would be in the pool for civilian residencies..... so technically wouldn't my chances "improve" since I am now considered for 2 pools (more application spots)?

Or do they just advertise the possibility for a Civilian residency but they don't actually allow for it.... essentially forcing people to do GMO's?

In the attached PDF from this thread:

http://forums.studentdoctor.net/showthread.php?t=792439

look at slides 11-15 for more information.

If you do not match then you have to do what they call an Undesignated Transition year.

Not matching into the Military residency of your choice doesn't mean that now you are allowed to apply to the civilian match. If you don't get the Residency of your choice (meaning Specialty) and have to do a Transitional year, you then have to apply for a civilian deferment and if that were granted you would then be able to go civilian. Civilian deferment is always a year to year thing with the Army always looking at cost/benefit with each applicant, so don't think you cant get one just realize that it might not happen and is not guaranteed.

Also as has been mentioned OBLC can be done before your first year but you have to be an early recipient of the Army HPSP, Nov-Jan, I got mine back in December and Im still having some paper work hang ups.

 

[halethsonofhama]

Awesome, thanks for pointing out the link. That PDF is full of great info.

 

[halethsonofhama]

So looking at the stats.. it doesn't seem like its too difficult to get the residency you want. With 86% getting their desired specialty and 89% of those getting their top 3 choices.... this sounds better than what I've seen trying to match in Civilian residencies.


Also I have a new question; are the students in the HPSP program typically on the lower side of the academic spectrum? I ask because i have only seen the stats for a few people in the program and they have all been pretty low. Maybe its a fluke... I just want to know because obviously I will be competing with these students. Knowing i'm not going up against the best of the best will significantly help my chances and my decision to join HPSP. (sounds very gunnerish I know....)

 

[Easy C]

Slides 16 and 17 show board scores in the different programs. Aside from grades I dont know how you might be able to compare HPSP students to the USUHS guys when fighting for residency spots. These pages show mean and min board scores and shows the 2008 civilian average for each. Id look into what the most current mean/min where for the civilian side to get a better gauge on how others do outside the military.

But also dont forget that the 89% of people getting their one of their top three choices doesn't show that some residencies only have 3 training locations and some only have 4 or 5.

Pay attention to slide 11:
Students declare specialty and rank all Army programs in that specialty

Example: I want to do pediatrics or family medicine. Well Peds only has 4 residency locations, NCC, MAMC, SAUSHE, and TAMC. I rank those spots in my preference because I have to rank all residency sites. No this sucks if I really dont want to go to SAUSHE, but I HAVE to rank it before I can rank a Family Medicine Residency.

1.MAMC
2.NCC
3.TAMC
4.SAUSHE
5.?

Now what I have heard/read/been told, one of those things, is that before I can rank another specialty I have to put down a Transitional Year. If that stands then I have to rank all 4 peds sites and then put down transitional year and not even get to rank a family medicine site.

Just some things to keep in mind.

 

[halethsonofhama]

I've tried to find it... but i honestly can't. But in regards to this transitional year... what exactly is it?

Does it add onto my PGY years? (for example.... if I do a transitional year, plus a 4 year residency will my active duty years be increased to 5?)

 

[Droopy Snoopy]

I've tried to find it... but i honestly can't. But in regards to this transitional year... what exactly is it?

Does it add onto my PGY years? (for example.... if I do a transitional year, plus a 4 year residency will my active duty years be increased to 5?)

You were correct, the other poster was incorrect. Throw out the intern year entirely, doesn't matter if it's TY or prelim or cat. With HPSP your AD commitment is the greater of your HPSP obligation or military/civ sponsored residency length. Examples:

-4 year HPSP, 5 year surgery res = 4 year AD
-3 year HPSP, 5 year surgery = 4 year AD
-4 year HPSP, 3 year IM = 4 year AD

I'm not Army, but realize that the referenced slide show is essentially a sales pitch designed to make Army medicine appear in the best light possible. It does have some good information though. The stickies are still good despite some of it being 4+ years old. The military is very slow to change...

You're incorrect that your 'chances' landing an EM spot are better because you're eligible for 2 both the .mil and civilian pools. First EM is typically MORE competitive in the services, for a few reasons probably but I think mainly because the military attacts more of the cowboy/hoo-ah types to begin with. Additionally, stud med students can lose out to below-average GMOs (in terms of boards, research, etc.) because of the way the military doles out points. Where I did my internship, 80% of the EM interns that year were prior service or GMOs.

There was talk of designating spots for med students, but again being neither Army nor EM I've no idea if that actually happened. Assuming nothing has changed, your match rate STRAIGHT OUT OF MED SCHOOL (note that this is not the same thing as 'class of 2010' as referenced on those slides) is significantly lower than 86%.

For example, the brass gets together and says, "4 years from now we're going to need 24 ER docs to compensate for attrition. We can train 18 at BAMC, Madigan etc. So we'll take the top 18 in terms of points and send 6 to the civ program of their choice. Everyone else becomes a GMO. Hypothetically you could have 15 GMOs and 15 senior med students applying. All 15 GMOs get a spot, as well as 9 M4s. =60% match rate.

 

[mbh11]

Haujun: Where are you currently an attending at? You obviously seem to have a good grasp on things and know answers to a lot of the questions I, and other HPSP's, have.

I am awaiting my decision for the March board for AF, still possibly considering Army, should hear back around April 16th is what my recruiter told me. Father-in-law is retired AF fighter pilot, along with other mentors being retired AF, and I've been pursuing HPSP since I began applying for med school so I'm hoping I have a good chance of being accepted.

My recruiter told me that I could do my officer training in AL this summer, prior to MS1, which would be the month of June, med school starts Aug 1 so no problems there, but I saw that most students do their training in between MS1 and MS2 you said? Is there a reason for that, is it a bad idea to do it prior to MS1? In my mind i think it would be better to just get that done and be able to devote next summer to visiting BAMC where I hope to get my residency..

I will be following this thread closely, love getting more info about this program. Very, very excited about military med as is my wife (she was born at moody AF base, and lived at bases in korea, hawaii, and others so she knows what military family life is like!)

 

[mbh11]

You were correct, the other poster was incorrect. Throw out the intern year entirely, doesn't matter if it's TY or prelim or cat. With HPSP your AD commitment is the greater of your HPSP obligation or military/civ sponsored residency length. Examples:

-4 year HPSP, 5 year surgery res = 4 year AD
-3 year HPSP, 5 year surgery = 4 year AD
-4 year HPSP, 3 year IM = 4 year AD

I'm not Army, but realize that the referenced slide show is essentially a sales pitch designed to make Army medicine appear in the best light possible. It does have some good information though. The stickies are still good despite some of it being 4+ years old. The military is very slow to change...

You're incorrect that your 'chances' landing an EM spot are better because you're eligible for 2 both the .mil and civilian pools. First EM is typically MORE competitive in the services, for a few reasons probably but I think mainly because the military attacts more of the cowboy/hoo-ah types to begin with. Additionally, stud med students can lose out to below-average GMOs (in terms of boards, research, etc.) because of the way the military doles out points. Where I did my internship, 80% of the EM interns that year were prior service or GMOs.

There was talk of designating spots for med students, but again being neither Army nor EM I've no idea if that actually happened. Assuming nothing has changed, your match rate STRAIGHT OUT OF MED SCHOOL (note that this is not the same thing as 'class of 2010' as referenced on those slides) is significantly lower than 86%.

For example, the brass gets together and says, "4 years from now we're going to need 24 ER docs to compensate for attrition. We can train 18 at BAMC, Madigan etc. So we'll take the top 18 in terms of points and send 6 to the civ program of their choice. Everyone else becomes a GMO. Hypothetically you could have 15 GMOs and 15 senior med students applying. All 15 GMOs get a spot, as well as 9 M4s. =60% match rate.

Very good info to know and be aware of. Im about to start MS1 so obviously I have a long way to go but I've worked in an ER for almost 2 yrs, my brother and his wife are ER docs, so I'm about 95% sure I want to do ER med, I love the ER and couldn't see myself really doing anything else, and it is my dream right now to get BAMC ER residency outta MS4...wishful thinking I know.. but residency match lists were just published yesterday from the school I'm attending and there was an MS4 who matched ER at BAMC! So that made me very, very happy to see.

You said 18 spots? is that 9 army and 9 air force? any indication that number will change within the next four years? Any reccommendations for someone like me who has a good idea of what/where they want to be? Visiting BAMC during MS1 and MS2 to get my name/face known down there? Or do those things even matter? Grew up in Texas and have been here for almost 20 yrs so I'm very inclined to that program...

 

[Barcu]

Haujun: Where are you currently an attending at? You obviously seem to have a good grasp on things and know answers to a lot of the questions I, and other HPSP's, have.

I am awaiting my decision for the March board for AF, still possibly considering Army, should hear back around April 16th is what my recruiter told me. Father-in-law is retired AF fighter pilot, along with other mentors being retired AF, and I've been pursuing HPSP since I began applying for med school so I'm hoping I have a good chance of being accepted.

My recruiter told me that I could do my officer training in AL this summer, prior to MS1, which would be the month of June, med school starts Aug 1 so no problems there, but I saw that most students do their training in between MS1 and MS2 you said? Is there a reason for that, is it a bad idea to do it prior to MS1? In my mind i think it would be better to just get that done and be able to devote next summer to visiting BAMC where I hope to get my residency..

I will be following this thread closely, love getting more info about this program. Very, very excited about military med as is my wife (she was born at moody AF base, and lived at bases in korea, hawaii, and others so she knows what military family life is like!)

Just wanted to address a quick point. I am AF HPSP starting M1 this fall. It seems that the AF wants you to do COT before M1, so I am ready to go this summer. I could have done it between M1 and M2 if I wanted to get a deferral, but they expected me to do it this summer.

I also looked into the Army, and I was told OBC was in between M1 and M2.

So, it looks like that is one way the services may differ slightly. You should probably expect to do COT this summer if you go AF.

 

[mbh11]

Just wanted to address a quick point. I am AF HPSP starting M1 this fall. It seems that the AF wants you to do COT before M1, so I am ready to go this summer. I could have done it between M1 and M2 if I wanted to get a deferral, but they expected me to do it this summer.

I also looked into the Army, and I was told OBC was in between M1 and M2.

So, it looks like that is one way the services may differ slightly. You should probably expect to do COT this summer if you go AF.

great to know, thanks. youre doing the may 31-july 1 COT then i assume? where are you from? what school are you attending?

 

[Droopy Snoopy]

You said 18 spots? is that 9 army and 9 air force? any indication that number will change within the next four years? Any reccommendations for someone like me who has a good idea of what/where they want to be? Visiting BAMC during MS1 and MS2 to get my name/face known down there? Or do those things even matter? Grew up in Texas and have been here for almost 20 yrs so I'm very inclined to that program...

Hey, just to clarify: I made those numbers up to illustrate how a reported 86% 'match' rate can be misleading. If you want hard, uptodate info on a particular program you should ask for it during your interview as an M4. Doing a 4th year clerkship is really all that is expected, required, or necessary to optimize your chances of matching in any particular milmed program. Visiting as an M1 is thoroughly useless; most if not all of the current faculty/residents will have separated, retired, PCS'd, or be deployed by the time you apply.

From what I know about BAMC's ED program though it's great. Not on par with some of your urban university programs in terms of trauma training, but they do get medevacs and burns from in-theater as well as good volume/acuity/range of pathology on the bread-and-butter med/surg stuff.

 

[244913]

So looking at the stats.. it doesn't seem like its too difficult to get the residency you want. With 86% getting their desired specialty and 89% of those getting their top 3 choices.... this sounds better than what I've seen trying to match in Civilian residencies.


Also I have a new question; are the students in the HPSP program typically on the lower side of the academic spectrum? I ask because i have only seen the stats for a few people in the program and they have all been pretty low. Maybe its a fluke... I just want to know because obviously I will be competing with these students. Knowing i'm not going up against the best of the best will significantly help my chances and my decision to join HPSP. (sounds very gunnerish I know....)

You'll do well in the Military.

The vast majority of Army HPSP applicants nowadays are osteopaths, some of whom come from the bottom rung DO schools. So the talent pool is marginal, if grades and MCAT scores mean anything. Years ago the HPSP program got top people from good allopathic schools, these days that's like seeing tits on a bull.

As others have stated, certain residencies are much more difficult to obtain in the Military match than in the civilian match. In 2008 Army ER had about a 50% match rate, whereas Allopathic civilians were looking at 93-94%.

Also, don't count on a civilian deferment, period. My year they gave one I believe. If you don't match then say hello to a transitional year and then some time in desert locales as a GMO or Flight Surgeon. That is unless you accept the proffered residency spots in Family Med, Internal Med, or Peds.

Do some research on this board before you sign up. If you've already signed up, then best of luck.

61N

 

[mbh11]

Hey, just to clarify: I made those numbers up to illustrate how a reported 86% 'match' rate can be misleading. If you want hard, uptodate info on a particular program you should ask for it during your interview as an M4. Doing a 4th year clerkship is really all that is expected, required, or necessary to optimize your chances of matching in any particular milmed program. Visiting as an M1 is thoroughly useless; most if not all of the current faculty/residents will have separated, retired, PCS'd, or be deployed by the time you apply.

From what I know about BAMC's ED program though it's great. Not on par with some of your urban university programs in terms of trauma training, but they do get medevacs and burns from in-theater as well as good volume/acuity/range of pathology on the bread-and-butter med/surg stuff.

I've of course picked through the BAMC ED residency website and read up as much as I can and last I saw there are 16 spots, 8 for Army and 8 for AF. I'm going to KCUMB-COM and their match list just came out and someone matched there for ER so I'm pretty pumped about that.


Yeah I figured any time during MS1 or MS2 wouldn't be too beneficial, I'll be back home in the DFW, TX for most summers/breaks so it's only a few hours away and I'll put in as much facetime possible when the time comes..

 

[Easy C]

Just wanted to address a quick point. I am AF HPSP starting M1 this fall. It seems that the AF wants you to do COT before M1, so I am ready to go this summer. I could have done it between M1 and M2 if I wanted to get a deferral, but they expected me to do it this summer.

I also looked into the Army, and I was told OBC was in between M1 and M2.

So, it looks like that is one way the services may differ slightly. You should probably expect to do COT this summer if you go AF.

Its been my understanding that the AF always makes HPSP guys do their training before their first year,unless as mentioned you are granted a deferral.

The Army allows you to do it before, if all your paper work goes through but the norm is after your first year.