First of all, I cannot believe the level of inane comments on this thread, however, as a graduate of USUHS and a current active duty physician who is informed on this topic, one must understand exactly what one is getting into when they join HPSP or go to USUHS. If one is contemplating entering USUHS just to leave it, you are not the type of individual even worthy of entering the school. If you want to see what it takes to be a military physician, I suggest that you see the apolitical movie "Fighting for Life" about USUHS and being a military physician. I believe that those of you who are utterly self serving, such as the one who began this thread appears to be, probably do not have what it takes.
First of all, I had no prior service and was a direct commission, so I was paid as a 2nd lieutenant with zero years of active duty (see pay rate on the web with tax free housing and food allowance and all health care paid for), I owed 7 years of active duty pay back after my training was completed (internship and residency). At that time, one could depart the military. One also needs to complete something called inactive ready reserve which is where you will be on a list for being called up if you do not serve 8 years of active duty or reserve time you may be called up for a certain amount of time after you leave (check specifics of this online).
Your pay includes board certification pay once you are board certified, incentive specialty pay once you have completed residency which is based on your specialty, as well as a MASP which is 15K per year payable when not in training. You are eligible for MSPs, multiyear specialty bonuses when you have completed your obligation which are 2,3,or 4 years available when you have completed you obligation. All of these bonuses are in addition to your basic pay which varies by rank as well as years in that rank. Expect to get promoted every 6 years. You graduate as a captain, get promoted to Major 6 years later and Lieutenant Colonel 6 years after that. Promotions become harder after the rank of Major. There are also military educational certifications that one must get along the way, Basic Training, Officer Advanced Course, and Intermediate Level Education ( the new name for the former Command General Staff College education).
In terms of getting out of your obligation, it is nearly impossible. One can try to pay one's way out of the obligation, usually $100 to $150k per year owed in time, but even getting a straight answer in this amount was difficult. I know of individuals who tried this and they were unable to figure out a way to be even in the position to pay this amount, although there are sporadic reports of this occurring.
In terms of being gay, the Army does not really care anymore unless it is truly disrupting unit cohesion, which is usually not an issue in the medical corps. Generally, if one is gay in the medical corps, they still have to fulfill their obligation.
In terms of getting out due for a medical reason, this additionally is difficult as they can always find something for you to do even if it is not in your specialty. I know of physicians who have had an amputation who are not separated from the military and still can contribute.
No one gets shot, although if you are AWOL (absent without leave) you better not try to obtain a medical license in the U.S. as you will be tried via the UCMJ (Uniform Code of Military Justice) and spend time in the Federal Penitentiary at Fort Leavenworth. You will have to try medicine in some other country which does not have an extradition arrangement with the U.S.
I regards to what I have gotten for my service to date, I will not sugar coat the benefits nor detractions. Benefits: far better training than civilian the local institutions where I trained during my residency, no loans, no health care deductions, not worrying about re-imbursements to make the hospital money thus the residency was more academic (no one has ever failed the boards for my specialty since the residency began over 20 years ago), interesting patients without having to see the dregs of society (no IV drug users, no gang related incidents - unless the military hospital where you work has a local trauma contract with the city where it is located , i.e. San Antonio) and lastly the ability to work with others who are all on the same team and primarily want to make things work for essentially altruistic reasons as this for some makes up for the detractions I have listed below.
Detractions- Lower pay even with the physician bonuses, fewer options where to work and no guarantee that you will get your first choice of these limited options after training, political power of other allied medical providers other than physicians due to rank (nurses, physical therapists, occupational therapists, hospital administrators) as they may have equal or higher rank as you thus they are less under the control of the physicians whose work support all of the other medical providers ( generally ) in the civilian world. Little control over your work environment thus if you hate your boss, you cannot just quit, you must stick it out until either he or she leaves or you PCS (permanent change of station - not really permanent, but it means you get assigned to another location), the hospital command may additionally decide that they want to add a particular new service for your specialty and say "get it done" even if you do not want to.
Not everyone can work in this environment, but to plan to cheat the Government via defaulting purposely on your loans or by planning the ill-advised going AWOL from USUHS probably indicates that you would be an unethical physician and perhaps another career choice is indicated, one which fits better with your lack of moral principles.
