Torn

[robertcandel]

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I am completely unsure of how to approach this situation. When I first read about the scholarship opportunities that the military provides I was quite intrigued, but after reading so many negative things on this board I'm becoming more apprehensive about whether or not I should take advantage of what the military has to offer. I would like some questions answered please. If I do go decide to go through with the military scholarship what type of training would be required of me? Would I have to go to boot camp? How often? anything like that. I know it says that I would have to have serve 45 active duty days a year but i don't know what that entails. If I did go to med would and used this scholarship am I required to complete my residency in the military or can I do a civilian residency and just work for them after i'm done. just unclear. How does pay as a resident and as an attending compare to civilian counterparts? What other options do I have for paying for med school?

 

[Banlioch]

You really need to read this forum and try searching. A brief summary that will hopefully save you from getting yelled at by everyone in the forum: You would go to an officer training course of some kind before graduation. ADT of 45days would be rotations at a military medical facility. Residency is either military or civilian, though civilian deferments seem hard to pull. You should make more in residency only to make less as you advance past that. For neurosurgeons, you really lose out, for FP you aren't strikingly different from civilian pay.

 

[resxn]

If I do go decide to go through with the military scholarship what type of training would be required of me? Would I have to go to boot camp? How often? anything like that. I know it says that I would have to have serve 45 active duty days a year but i don't know what that entails. If I did go to med would and used this scholarship am I required to complete my residency in the military or can I do a civilian residency and just work for them after i'm done. just unclear. How does pay as a resident and as an attending compare to civilian counterparts? What other options do I have for paying for med school?

1 - training. Dumb, don't worry about that. You go to Officer Training School in Alabama which is essentially a 6 week or less course where they tell you military protocol and start every sentence with "don't sleep with enlisted folks."

2 - Your 45 AD days can be served in a number of ways. I did each of mine as a 1 month rotation at an AF base in some specialty SubI. In fact I did 2 of those months in my 4th year which they were ok with. Some people have worked out a AD tour at their home school. Even though I was AD for 45 days, I was only on base for 30 because that's the way my school required it to work. I still got paid for 45 though which was nice.

3 - As far as residency goes, they will try to put you in a military residency. The Air Force needs come first. If they don't fill slots, you'll get pulled into it. Also, if they don't need what you are going into, they won't let you go into it. (e.g. if you want derm, but AF doesn't project a need for derm, you won't be allowed to apply for derm)

4 - You make less than 1/2 as a surgical specialist in the military as an attending than the civilian counterpart. As for pimary care, the discrepancy is not as big. As a military resident you will make close to double what your civilian counterpart makes.

5 - borrow, commit to a rural practice location, marry wealthy, or something else. I didn't explore many other options because I was blinded by the military offer. Not that I would have done something different necessarily, but I would have liked to know. But my commitment is so short, I'm not as hurt as others.

 

[colbgw02]

1 - training. Dumb, don't worry about that. You go to Officer Training School in Alabama which is essentially a 6 week or less course where they tell you military protocol and start every sentence with "don't sleep with enlisted folks."

2 - Your 45 AD days can be served in a number of ways. I did each of mine as a 1 month rotation at an AF base in some specialty SubI. In fact I did 2 of those months in my 4th year which they were ok with. Some people have worked out a AD tour at their home school. Even though I was AD for 45 days, I was only on base for 30 because that's the way my school required it to work. I still got paid for 45 though which was nice.

3 - As far as residency goes, they will try to put you in a military residency. The Air Force needs come first. If they don't fill slots, you'll get pulled into it. Also, if they don't need what you are going into, they won't let you go into it. (e.g. if you want derm, but AF doesn't project a need for derm, you won't be allowed to apply for derm)

4 - You make less than 1/2 as a surgical specialist in the military as an attending than the civilian counterpart. As for pimary care, the discrepancy is not as big. As a military resident you will make close to double what your civilian counterpart makes.

5 - borrow, commit to a rural practice location, marry wealthy, or something else. I didn't explore many other options because I was blinded by the military offer. Not that I would have done something different necessarily, but I would have liked to know. But my commitment is so short, I'm not as hurt as others.

To clarify, not everyone goes to Alabama. The Army does OBC in San Antonio, TX, for example.

I can't really stress this enough - don't do it for the money. I know that $200K seems like a crapload of money right now, but - depending on your specialty - it won't seem nearly as bad when you're out of residency. Also, many practices offer loan repayments as incentives to join, kind of like a signing bonus.

 

[robertcandel]

5 - borrow, commit to a rural practice location, marry wealthy, or something else. I didn't explore many other options because I was blinded by the military offer. Not that I would have done something different necessarily, but I would have liked to know. But my commitment is so short, I'm not as hurt as others.

You said your committment was is short so it isn't that bad. I'm just curious what your specialty is. Also do you feel like your really being set back career wise by the four year committment you've made?

by the way thanks to everyone who responded.

 

[orbitsurgMD]

I am completely unsure of how to approach this situation. When I first read about the scholarship opportunities that the military provides I was quite intrigued, but after reading so many negative things on this board I'm becoming more apprehensive about whether or not I should take advantage of what the military has to offer. I would like some questions answered please. If I do go decide to go through with the military scholarship what type of training would be required of me? Would I have to go to boot camp? How often? anything like that. I know it says that I would have to have serve 45 active duty days a year but i don't know what that entails. If I did go to med would and used this scholarship am I required to complete my residency in the military or can I do a civilian residency and just work for them after i'm done. just unclear. How does pay as a resident and as an attending compare to civilian counterparts? What other options do I have for paying for med school?

The scholarship recipients have to go to a six week officer basic course. It isn't so bad. They make you get up early and run and do calisthenics. The day is mostly spent in classes. There are goofy requirements such as having to march when travelling on foot on base in groups larger than two. Depending on your branch, you might have to take little instructional courses that are service specific (like shipboard firefighting and damage control, if you are Navy). They teach you the basics on protocol, etiquette, uniforms and other things to ease your transition to military life. I liked my summer in Newport. I'm not sure where they are doing this now; I heard Pensacola NAS, but others more recent might be a better source of information.

Your other 45-day periods are spent either at one of your clinical rotations at your school, for which you apply for a waiver and which is a formality, or you can spend elective time doing a clerkship at a military medical facility. You also have to apply to do that and get travel and lodging orders.
That isn't too hard to do either.

Avoiding debt is a virtue the services like to take advantage of. From the applying student's perspective, it is a powerful incentive. You should give yourself the benefit of an independent opinion, which are in no short supply in these pages. Student loan debt is more managable than you may be led to think, even when you are looking at the $200K figures many anticipate finishing medical school with. It would be worthwhile to talk with people who are out of training and who are repaying their loans to learn the facts.

What is almost impossible to quantify for a potential applicant is the value of the privilege of completing your training after finishing medical school, as opposed to being removed from training and sent to do repayment service as a GMO or similarly incompletely-trained practitioner. You forfeit a significant and valuable opportunity to choose the location and timing of your training when you sign on with HPSP, and you trade that for assignments to duty stations whose quality and support can vary significantly from adequate to criminally derelict, and unfortunately you will have little power to shape those circumstances once assigned. Part of the experience is learning to make the best of those limitations and your own limited training. For some, things work out OK, but for a significant number of others they don't, and that is one of the major criticisms of the HPSP accession program. Most of the services treat it as nothing more than an expedient way to get graduates who they can then assign to billets with no more than the minimum amount of postgraduate training necessary to get a license, not a whole residency. The services then send them out to situations where they will have to function as if they had more training than they were permitted and are also held to standards that would generally expect more training. It is really a dishonest and ethically compromised practice. It does wrong to both the doctors who deserve better and longer opportunities to train and to their patients who deserve to have better-trained physicians, at least as well-trained as they would normally see in the civilian world. As things stand, they don't. The military has advanced over the years dubious and disingenuous arguments that the results of their practices are no worse than similar organizations. That is self-serving and morally bankrupt, which reflects very poorly on the quality of the military services' leadership over the recent years--a leadership that prefers expediency and cost-containment to quality, education and excellence.

 

[resxn]

You said your committment was is short so it isn't that bad. I'm just curious what your specialty is. Also do you feel like your really being set back career wise by the four year committment you've made?

by the way thanks to everyone who responded.

Well, my commitment is for 3 years not 4, I paid for my first year of med school with loans.

Overall, considering benefits, salary, HPSP stipend, civilian residency salary, interest rate on outstanding loans, current salary, my starting salary next summer, etc. I break out after 3 years at almost dead even to those residents who graduated within one year of me in my specialty (ENT). If I had a 4 year commitment, I'd fall significantly behind them.

Where I feel set back from a professional standpoint is that my skills have waned since I left residency. I left having done over 3000 surgeries and felt like I could do anything I wanted. Now I feel uncomfortable doing some more complex cases because I don't have the support or the case load to do the complex stuff. I don't feel setback financially b/c of my short commitment and the numbers show I'm not.

 

[The White Coat Investor]

You said your committment was is short so it isn't that bad. I'm just curious what your specialty is. Also do you feel like your really being set back career wise by the four year committment you've made?

by the way thanks to everyone who responded.

I am set back financially and skill-wise. It was unusual for me not to intubate at least twice a month as a resident (frequently several times a week). I have intubated no one since going on active duty. I typically placed several central lines a week as a resident, I have done none since going on active duty. I have not seen one myocardial infarction and only one arrythmia that actually needed treatment in 4 months. 1 septic patient, 1 really sick kid, and zero trauma. At least the trauma part will be better come next fall when I'm deployed. Hopefully I still remember how to take care of it.

I could have gotten out of medical school for about $75K of loans. In private practice I would have that paid off easily by next summer (not that I would have, since it would be consolidated at 1.9% like the rest of my medical school class. 2003 was a great year for loan consolidation). Yet my commitment goes for another 3 1/2 years (actually, closer to 4 if I take my ISP payment that last year.)

 

[BomberDoc]

My career has been halted for 4 years while I do my payback as a knucklehead untrained GMO flight doc. My classmates are finishing their residencies and I'm applying for mine. The Air Force will most likely screw you out of your residency and send you to the sandbox unless you are prior service or an Academy grad. These folks have enough "points" to match. The rest of us get the shaft.

 

[Ex-44E3A]

I found it was not a good financial deal to do HPSP... but I had no idea what I'd be worth (or even what specialty I'd be in) until it was too late. That's one of the fundamental problems with HPSP... you sign on the dotted line long before you have enough information to make an informed choice.

As an ER doc, salaries very widely. If you don't work that much and belong to a national contract group (where you're an independent contractor and get paid hourly), your salary is still higher than the military, but not by a huge amount. If you work for an independent group that does its own billing, has profit-sharing, partnership, and you work hard, you can triple your military salary.

It's all a matter of how hard you want to work, and where you want to work.

I had several offers coming out of the military (my colleagues coming fresh out of residency had similar offers) that were double+ my military salary. Also consider that they included about 35-40K retirement plan contribution per year. They also had benefits. They also offered a partnership track with fewer shifts as you advance, and more money (profit-sharing).

So in my years of military payback, I not only wasn't building any kind of equity in a retirement plan, but my salary was low, and my "sweat equity" wasn't going toward any kind of partnership track. Losing time also hurts you, because EM is a rough specialty...(and we don't even have it as bad as some surgeons). ER has a high burn-out rate, and it gets a lot harder to keep up that frantic ER pace as you get older... it behooves you to make your bones when you're young enough to handle the pace and stress. You don't see too many old ER docs duking it out in a high-volume department... and there's a reason those who do appear "older than their stated age." (That said, those old, salty ER docs can be fountains of knowledge).

A lot of docs escape from EM and work urgent cares or low-volume places as they burn out.

To answer your question: I'd avoid HPSP if you're doing it for the money... you'll be kicking yourself later if you do.

 

[DiveMD]

I am completely unsure of how to approach this situation. When I first read about the scholarship opportunities that the military provides I was quite intrigued, but after reading so many negative things on this board I'm becoming more apprehensive about whether or not I should take advantage of what the military has to offer. I would like some questions answered please. If I do go decide to go through with the military scholarship what type of training would be required of me? Would I have to go to boot camp? How often? anything like that. I know it says that I would have to have serve 45 active duty days a year but i don't know what that entails. If I did go to med would and used this scholarship am I required to complete my residency in the military or can I do a civilian residency and just work for them after i'm done. just unclear. How does pay as a resident and as an attending compare to civilian counterparts? What other options do I have for paying for med school?

DON'T DO IT!!!!!!!!!!!!!!!!!!

 

[USAFdoc]

I am completely unsure of how to approach this situation. When I first read about the scholarship opportunities that the military provides I was quite intrigued, but after reading so many negative things on this board I'm becoming more apprehensive about whether or not I should take advantage of what the military has to offer. I would like some questions answered please. If I do go decide to go through with the military scholarship what type of training would be required of me? Would I have to go to boot camp? How often? anything like that. I know it says that I would have to have serve 45 active duty days a year but i don't know what that entails. If I did go to med would and used this scholarship am I required to complete my residency in the military or can I do a civilian residency and just work for them after i'm done. just unclear. How does pay as a resident and as an attending compare to civilian counterparts? What other options do I have for paying for med school?

1) If you join, you will have a 99% chance of regretting that decision.
2) If you join, you will likely not regret that decision until after residency (assuming the military does not GMO you. My experience is that military residency (primary care), USHUS, OCS etc. are generally not terrible. The problem begins once you are the doc, and at that point the stench of military medicine will fill your nostrils like a good pint or two of melena on the hospital floor.😱

 

[island doc]

for FP you aren't strikingly different from civilian pay.

This past issue of Medical Economics magazine has an excellent article on physician compensation by specialty. I think that you will find that there are many civilian FP's who are earning more than their military counterparts. Myself included.

 

[island doc]

dubious and disingenuous arguments

aka lies and deceptions