USAF HPSP - Residency Questions

[DocOckk]

Hey everyone, I've been accepted to the USAF HPSP. I've got questions about residency placements and civilian deferments. I'm interested in anesthesia and, as of now, will be attending a newer DO school. How does civilian deferment work? Can I rank that as my preference and pursue civilian residencies if I don't match within the military, or am I forced to take a transitional year? I understand anesthesia can be competitive and just wanna know all the facts before I sign.

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[SirGecko]

They have to give you permission to do a civilian residency. You would apply for anesthesia and rank the military programs and civilian deferment in whatever order you are trying to rank them. If you don’t match civilian deferment you would have to pursue some other intern year. Civilian deferment isn’t really a backup though, it’s sometimes (often?) more competitive than the military programs.

 

[Niwrad]

Hey everyone, I've been accepted to the USAF HPSP. I've got questions about residency placements and civilian deferments. I'm interested in anesthesia and, as of now, will be attending a newer DO school. How does civilian deferment work? Can I rank that as my preference and pursue civilian residencies if I don't match within the military, or am I forced to take a transitional year? I understand anesthesia can be competitive and just wanna know all the facts before I sign.

In the AF, like in the other branches, you do an early match where you rank each of the military run residency sites, and additionally rank civilian deferment as its own site.

You also rank military run internship years.

Everyone who’s not matched to a military site will be selected into civilian deferment.

It varies from year to year depending on the HPERB (health professions educational requirements board) which is released in June of each year that is a large spreadsheet of all available positions that the Air Force has decided they will fund for HPSP students and graduates.

Generally speaking, there are large numbers of civilian deferment positions in the Af.

In the ballpark of around 200 civilian deferment positions and around 800 total positions so about ~~1:4 ratio across all specialities.

So in my opinion, you would rank civilian deferment after military sites even though you also apply to civilian sites via ERAS because it is relatively ‘uncompetitive’. In comparison to Army or Navy, the ratio is much more in favor of military sites.

 

[Correlate Clinically]

Basically, when applying you have two systems. One is the military (military programs, AD non-categorical internships, civ deferred/sponsored) and the other is the normal civ match. You can apply to a civ program all you want, but you must have permission from the military to do it regardless of acceptance (you need to have a differed or sponsored slot). The military match trumps any civilian program acceptance. You could have a letter from the best program in the country, but if the military doesn't have a spot for you that year it doesn't matter.

Keep in mind, the availability of deferment will vary from year to year and from specialty to specialty. The military will preferentially fill AD slots.
If you apply in a year when deferments are not necessarily being offered or when there is a small applicant pool, you may be pushed to an AD slot. If the pool interested in that particular specialty is heavily weighted towards HPSP graduates, the competition for a deferred spot can actually be stiffer than for an AD program.

As an example, you could rank deferment as your first choice. But if there is 1 fewer applicant than AD slots, you will most likely get an AD slot.

It was a long time ago, but the year I applied my specialty had exactly 0 deferred spots. Fast forward a few years and they offered 10 or more. The last few years we have had a decent number, but it's starting to draw down again.

Like many things, it all depends on timing.

 

[Incognito32]

Basically, when applying you have two systems. One is the military (military programs, AD non-categorical internships, civ deferred/sponsored) and the other is the normal civ match. You can apply to a civ program all you want, but you must have permission from the military to do it regardless of acceptance (you need to have a differed or sponsored slot). The military match trumps any civilian program acceptance. You could have a letter from the best program in the country, but if the military doesn't have a spot for you that year it doesn't matter.

Keep in mind, the availability of deferment will vary from year to year and from specialty to specialty. The military will preferentially fill AD slots.
If you apply in a year when deferments are not necessarily being offered or when there is a small applicant pool, you may be pushed to an AD slot. If the pool interested in that particular specialty is heavily weighted towards HPSP graduates, the competition for a deferred spot can actually be stiffer than for an AD program.

As an example, you could rank deferment as your first choice. But if there is 1 fewer applicant than AD slots, you will most likely get an AD slot.

It was a long time ago, but the year I applied my specialty had exactly 0 deferred spots. Fast forward a few years and they offered 10 or more. The last few years we have had a decent number, but it's starting to draw down again.

Like many things, it all depends on timing.

In the AF, like in the other branches, you do an early match where you rank each of the military run residency sites, and additionally rank civilian deferment as its own site.

You also rank military run internship years.

Everyone who’s not matched to a military site will be selected into civilian deferment.

It varies from year to year depending on the HPERB (health professions educational requirements board) which is released in June of each year that is a large spreadsheet of all available positions that the Air Force has decided they will fund for HPSP students and graduates.

Generally speaking, there are large numbers of civilian deferment positions in the Af.

In the ballpark of around 200 civilian deferment positions and around 800 total positions so about ~~1:4 ratio across all specialities.

So in my opinion, you would rank civilian deferment after military sites even though you also apply to civilian sites via ERAS because it is relatively ‘uncompetitive’. In comparison to Army or Navy, the ratio is much more in favor of military sites.

Point of confusion: Are the deferred spots reflected in any given years' HPERB? I recall reading about civilian deferments on a FB HPSP Group and the number of people who said they matched civilian deferred did not match the number of civilian deferment spots indicated in the HPERB. For example, I counted at least 3 individuals who matched civilian deferred path in 2021 but the 2021 and 2022 HPERB both list "0" for DEF/RDEF under path.

In regards to permission to pursue a deferred residency: Is that obtained before or after ranking?

Thanks in advance.

 

[Niwrad]

Point of confusion: Are the deferred spots reflected in any given years' HPERB? I recall reading about civilian deferments on a FB HPSP Group and the number of people who said they matched civilian deferred did not match the number of civilian deferment spots indicated in the HPERB. For example, I counted at least 3 individuals who matched civilian deferred path in 2021 but the 2021 and 2022 HPERB both list "0" for DEF/RDEF under path.

In regards to permission to pursue a deferred residency: Is that obtained before or after ranking?

Thanks in advance.

#1 HPERB (Health Professions Edu Req's Board) is branch specific, so the numbers may vary between branches.

#2 Regarding deferred residency - permission to pursue civilian deferred residency is prior to civilian rank order list. For military rank order list, the rank order you use is the request to pursue civilian deferred residency (i.e. ranking civilian deferred residency higher for example).

#3 Also at the top of every HPERB is the following disclaimer with minor changes, but I've highlighted the key point:

The training positions authorized in the 202[x] HPERB may be subject to change based on the needs of the United States [Air Force]. IAW DODI 6015.24,GME programs are conducted jointly and in military medical treatment facilities to the maximum extent practicable. Therefore, a priority will be placed on filling military GME positions. Additionally, there is a chance that some positions advertised in this document may not be selected for fill at the Joint Graduate Medical Education Selection Board and there could be some specialties that match more candidates than originally advertised.

 

[Incognito32]

#1 HPERB (Health Professions Edu Req's Board) is branch specific, so the numbers may vary between branches.

#2 Regarding deferred residency - permission to pursue civilian deferred residency is prior to civilian rank order list. For military rank order list, the rank order you use is the request to pursue civilian deferred residency (i.e. ranking civilian deferred residency higher for example).

#3 Also at the top of every HPERB is the following disclaimer with minor changes, but I've highlighted the key point:

Understood. Much appreciated!