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Warning about joining the NHSC!

Discussion in 'NHSC | PHS | IHS' started by andrea, Sep 24, 2012.

  1. andrea

    andrea 10+ Year Member

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    I am in my third year of pay back for the NHSC. When I was a pre-med I used to come on these forums a lot and wished that someone would tell us the down and dirty truth about what I would be getting into as a NHSC scholar. So, here I am. I want you to see what it's like from the other side so you can decide if it's really what you want.

    I always knew I wanted to be a family doc, so that wasn't a concern for me. I was really more curious about where I would end up practicing once I finished residency. The stipend during medical school was great, and knowing my medical education was paid for was nice.

    BUT. In my last year of residency, the rules for family medicine were that anything with a HPSA score of 14 or higher was ok for a NHSC scholar. I interviewed at multiple sites and received a contract from my favorite one. I was required to attend a NHSC convention, and had planned to sign my contract the next month. At the convention, they casually mentioned to hundreds of us that they decided to change the rules. The new rules would state that the HPSA score for a scholar would be raised to 17, which greatly lowered that number of sites available (not to mention that these were the less desirable sites that no one wanted).

    I was shocked! I had to hastily cancel my commitment to my original option and scramble to find a new site (out of state) before I finished residency. Lesson learned: NHSC can change the game on you.

    Now I am in practice at a place I don't love. I am trying to move back to my home state and found a place that was considering repaying my loans to NHSC. We all know the rule - if you break the contract, you'll owe 3 times your student loans. What they don't tell you in the contract is that you will also have to pay back 3 times your stipend plus 3 times the interest on all of those things. In order to leave my job after 3 years instead of 4, I would have to pay $600,000!!! No kidding, they sent me the calculations and they were not kidding.

    So there is no way I can get out of it. I am a prisoner for the next year. If you are ok with that, do sign up. But beware and know there is more to it than what the contract states. Good luck.
     
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  3. smq123

    smq123 Roy Lichtenstein SDN Advisor SDN Administrator 10+ Year Member

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    Thanks for the warning.

    I think this is why the NHSC changed the way they did things. Now, you MUST go to the scholars convention before they will allow you to interview anywhere. The scholars conference is like the unofficial start to interview season. So stories like yours shouldn't happen again.

    You have to tell the NHSC where you are invited to interview; they will investigate the site and make sure that it will fulfill your obligation before they will agree to reimburse your interview and travel costs.

    Sorry things ended up not working out for you. :( Hang in there for just a bit longer.
     
    Mrsbear1 likes this.
  4. cali-ob

    cali-ob Chief Resident 5+ Year Member

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    back where I belong!
    I second that! In fact, I came onto this forum today specifically to warn premed and med students...you would be better off doing loan repayment or just looking for a job that will give you loan repayment. Things can change drastically from the time that you sign and the time that you start working. I am working at a place that I have hated at worst and tolerated at best. There is a high turn over rate, I drive 50 miles each way to work so that my kids can attend decent schools, and the admin is incompetent. I want to leave and never come back every day, but of course, 2 million dollars in debt hanging over your head makes that impossible. I waiver between trying to just put my head down and push through it, and wanting to find a place to transfer to. The issue is, transfering with the NHSC is difficult. If you've ever tried to contact them about anything you know how frustrating dealing with them can be. And really, who's to say one place is better than the others? I actually thought the clinic I'm at now would be one I could stay at for a long time. No way now. Think carefully, it's not all about money. There is no price for mental peace and sanity
     
  5. BuddyTheElf

    BuddyTheElf Smiling's my favorite. 2+ Year Member

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    Thanks for the warning Cali and Andrea!
     
  6. goprisko

    goprisko

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    I'm a vet. Vietnam.. . . Volunteered.. .. . Knew from the onset that it was
    my duty to go where sent, when sent.

    It seems to me that some of you weren't aware of this sort of thing, or lived in denial regarding it. The thing I am discussing, is Uncle Sugar never gives anything away. There is always a catch.

    The alternative is doing what I did to pay for my tertiary education. I went to Purdue full time 16-18 credit hours/ semester and worked ~25 hours / week during each semester and ~ 50 hours / week during vacations to pay the bills.

    Oh, I lived in a cellar. It was the only place cheap enough.

    So, if NTSC pays off your student loans, and provided you with a scholarship, it was for the express purpose of sending you to some crap place no one else would go, so that place had a doctor... you!

    If you want to share experiences, let me tell you about Outapi District Hospital, Namibia. It was a "MASH" unit during the war. We couldn't just go out into the veldt because of the millions of mines and ordinance scattered about. The canal from Ruacana to Oshakati, had shistosomiasis. We boiled our water. Then brushed our teeth. Livestock wandered the corridors and wards.
    When I got there, the autoclaves were OOC. All surgical instruments and linens and smocks were shipped 300 km RT to Oshakati. The emergency generator was out too. Everest and the surgical team, more than once completed a procedure using flash lights.
    My first task as infrastructure specialist, was fixing both. I had them up and running within 10 days. Then we had to convince the patients to use the latrines located in the front of the clinic, instead of squatting whenever and whereever it suited.

    I'm sure we can have an interesting chat.

    INDY
     
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  7. survivordo

    survivordo Gettin' through it 2+ Year Member

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    You never get something for nothing... beware those bearing gifts

    Survivor DO
     
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  8. ferning

    ferning SDN Lifetime Donor Lifetime Donor Classifieds Approved 2+ Year Member

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  9. USeF

    USeF sunny L.A. 10+ Year Member

    Respect.
     
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  10. NontradCA

    NontradCA American Hero 5+ Year Member

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    Trump Tower
    I love you.
     
  11. ohnoyoudiint

    ohnoyoudiint 2+ Year Member

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    My experience with the NHSC loan repayment program has also been a horror story. I think the terms of the contract should be criminal. Where else can a contract expect 3 times the money lent, plus interest? It reminds me more of the tactics used by organized crime -- the terms of a loan from the mafia.

    I graduated from dental school in 2010. I applied to various loan repayment sites in New England. I wanted to do the loan repayment program rather than the scholar program because I wanted to have more control over where I worked. I am married and I wanted my husband to also be able to find work wherever I was located. His job is more of a city job - business analyst/project management. When I graduated from dental school, I also knew I would want to start a family and be relatively close to my Mom who is in New England. I applied for various jobs in New England, and settled on a location in Eastern Connecticut. I first applied for the NHSC loan repayment program a couple of months after I started working. And my application was denied! I had already committed to the area and the job, and we had bought a house there. I wasn't defeated though, because I liked where I worked and the other staff in the dental department. Decent base salary, cute house. We were pretty happy anyway. I got pregnant. :) & I applied for the next application cycle.

    This time, my acceptance to the NHSC program came a couple of weeks after my baby was born. She was born 2 months early because I had severe preeclampsia. My health was a wreck when I had her, but the doctors assured me I would feel better in 6-8 weeks. Although I was very ill, I hoped my life would return to normal shortly and I'd be back working when my maternity leave was up. I signed the contract. Unfortunately, my health never did improve. It only deteriorated. None of the doctors I consulted knew what was wrong with me - primary care, neurologist, cardiologist, etc. No one could figure it out. But I was suffering with double vision, vertigo, migraine, back pain, neck pain, nausea, etc. I could not responsibly treat patients this way. I hardly had the strength or focus to open a box of cereal, so really treating patients was impossible, and very much out of the question. And I was not able to go back to my job when the FMLA was up. My employer at the NHSC site fired me the day my FMLA was over. I honestly thought their firing me would break the contract with the NHSC. After all, this was the loan repayment program, not the scholar program. So, the employment at the site I had chosen, and upon which my application was contingent, fell through, and I therefore thought I would no longer qualify for the program and it would be over. But no, a week after I was fired, I got an e-mail talking about default proceedings and debt prospectives. So, here I am - sick and recently unemployed, and now with threatening correspondence from the NHSC about default? LET ME EMPHASIZE THIS POINT ---- I NEVER GOT THE $60,000 from them!! I NEVER GOT A PENNY FROM THEM!!! And yet, they were now expecting me to pay them money????

    For 4 or 5 months I was corresponding with the NHSC about this. It was very stressful for me. But, I finally wrote them a strongly enough worded letter, that they stopped contacting me. I thought it was over.

    I went over a year un-diagnosed and unemployed. Finally, 14 months after the severe preeclampsia. I was finally diagnosed with a condition, which is permanent. After treatment for 6 months post-diagnosis, I was able to do some continuing education and to regain my dental license. I now work one day a week at a slow-paced private practice where I have control over my day and the owner of the practice will do the difficult oral surgery, endodontics and prosthodontics. It is working for me for now because it is not too stressful. At the NHSC site I was over-worked and rushed and too stressed. I can't do a job like that now. It was a battle for me just to regain the confidence to do this.

    Just last week I got another letter from the NHSC. It has been 2 years since I first signed the contract. It has been 16 months since they last tried to contact me. & now again they telling me I could be liable for the $7,500 a month for every month of unfulfilled service - for me that is the entire 24 months so = $180,000. Plus interest at the prevailing rate? Let me say again - I NEVER GOT ANY MONEY FROM THEM!!!! It's ludicrous and sickening. It's really unfathomable to me. I try to explain this story to people that don't know anything about the NHSC, and they really can't believe it's true. This is supposed to be a noble/charitable government agency, helping the underserved population and helping doctors burdened with debt. But, what charitable organization would have a contract so despicable - which for me is akin to making the participants indentured servants?

    I went through a lot of hassle to get all of my documents together to participate in this program, and really all along I was just jumping through hoops to sign myself up to be harassed for years.

    If you have any plans to start a family while doing the NHSC --- don't do it. If you think you might get sick while participating with the NHSC - don't do it. If you expect them to be reasonable and rational and treat you with respect -- don't do it.

    That is my horror story.
     
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  12. simpler2

    simpler2 person 10+ Year Member

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    For those med students and residents reading this thread in horror, please be aware that there are MANY more success stories from NHSC scholars and loan repayors than there are horror stories. Mine for example, I am at the site I would likely be working anyway by choice, get paid my regular salary and don't have to worry about 250K that I would have had to deal with in med school loan debt. All of this at the price of filling out an annoying form occasionally. If you do your research, play by the program rules, and plan for employment way in advance; then in most cases you will have no problem finding happy employment at a site that meets program specifications.
     
  13. PhoenixFire

    PhoenixFire 5+ Year Member

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    What is HPSA score, how is it determined, and what role does it play?
     
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  14. smq123

    smq123 Roy Lichtenstein SDN Advisor SDN Administrator 10+ Year Member

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    HPSA stands for Health Professional Shortage Area. It is a measure of how underserved a particular geographic area is, in terms of access to health care. The Health Resources and Services Administration (HRSA, a subset of the federal Department of Health and Human Services) calculates HPSA scores regularly. You can find out more at this website: http://hpsafind.hrsa.gov/HPSASearch.aspx

    The HPSA score matters because NHSC scholars can only fulfill their service payback in a site above a certain HPSA score. That minimum required HPSA score changes each year.

    Hope this helps. If you are still unsure, let me know.
     
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  15. puppylatte

    puppylatte

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    You might want to lawyer up.
     
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  16. fixemupnp

    fixemupnp

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  17. fixemupnp

    fixemupnp

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    Hi OHNOYOUDIDNT...I'm curious to know what is happening now with the NHSC. I have a similar situation. I never received a dime. They sent me a debt collection notice to pay 160,000+ in penalties. I think we should petition on Change.org.

    Please let me know where your case stands. Did you get a lawyer by chance and if you did, what is their name?
     
  18. fixemupnp

    fixemupnp

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    I think our problem with NHSC is the indentured servant attitude and the demand for 3 times interest and penalties.
     
  19. B-Swizzle

    B-Swizzle

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    How many years are you required to serve under NHSC? Is it determined based on the HPSA score, is there some equation? Lastly, are there private loans out there that allow loan forgiveness for the same high HPSA scored clinics?

    Thanks for any advice in advanced, I've been up and down these forums looking for a way to pay for med school.
     
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  20. smq123

    smq123 Roy Lichtenstein SDN Advisor SDN Administrator 10+ Year Member

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    Your service obligation depends on how long you had the scholarship for.

    4 years of scholarship = 4 years of service.
    3 years of scholarship = 3 years of service.
    2 years of scholarship = 2 years of service.
    1 year of scholarship = **2** years of service. (It is a minimum of 2 years)

    There is also another program, called Students to Service. That program will start paying off your loans while you are a resident, for a minimum of 3 years of service.

    There are no private loans, that I am aware of, that offer the same loan forgiveness. Some hospital systems (generally in very very rural areas) will offer some loan repayment for you, but not all hospitals offer this.
     
  21. styphon

    styphon Senior Member 10+ Year Member

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    The NHSC and NHSC loan repayment only pay for federal loans, not private - even if you took federal loans and then "consolidated" them thru a private company.

    Some companies/clinics/hospitals will give you a "loan repayment" bonus when you sign on - but this is taxable and basically another name for "sign on bonus".
     
  22. Dressagequeen 247

    Dressagequeen 247 2+ Year Member

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    So how do you choose a site do you check out the area first, spend some time there before deciding? How about living situations, do u rent for all of those years or purchase something cheap but affordable (say if your going to be there a while)?? This is a very interesting program that sounds like a dream for some ( if they are prepared and read the fine print) and a nightmare for others.
     
  23. smq123

    smq123 Roy Lichtenstein SDN Advisor SDN Administrator 10+ Year Member

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    Like any other job, you have an interview first. The NHSC pays for you to go interview, if it is more than 50 miles away from where you are currently living.

    I would advise against buying a house right away, but that goes for everyone. They say that the majority of physicians will not stay in their job for more than 3 years.
     
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  24. JehNissi

    JehNissi

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    Hi! Im so sorry what happened to you..unfortunately except for the getting sick part, mine is the same as yours. I hope we could talk more about this perhaps through email? other than this thread as I don't feel that comfortable just yet. Thanks and hoping to hear from you soon.
     
  25. JehNissi

    JehNissi

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    Hi fixmeupnp! I would like to correspond with you about my experience. Not sure how to reach you through your personal email but I'm hoping I can talk to you soon someway or the other but not through this thread. Thanks!
     
  26. WGSgrad

    WGSgrad

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    Unless you're the NHSC apparently, then it seems you get a whole lotta something for nothing if the posters in this thread are to be believed.

    While I take most things with several grains of salt, the idea that this could happen is certainly a bit...off putting (?) and might encourage me to find another way to finance my education and future practice in undeserved areas.
     
  27. Notsosuperman

    Notsosuperman 5+ Year Member

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    I'm not sure if this was the case in the past, but currently the program guidance states loan repayment is for federal or commercial loans. If by "private" you mean a commercial loan, it is eligible for repayment. If by "private" you mean a loan from a foundation or uncle Harry, then it is not covered. Here is a quote from the FAQ on the NHSC website:

    Your loans must have been obtained to cover school tuition, other reasonable education and living expenses associated with the undergraduate or graduate education that led to your health professions degree. Only loans provided by Federal, State and local entities, as well as commercial institutions qualify. Education loans that have been paid in full, are in default, or were obtained for someone other than the applicant do not qualify. Personal lines of credit, credit card debt, and debt associated with relocation or residency programs, do not qualify for repayment. For a complete listing of loans that qualify for repayment under, see pages 7-8 of the 2015 Application and Program Guidance(PDF - 383 KB)​

    I am a dentist finishing my 2 year obligation for a NHSC scholarship this September. There certainly were moments when it was tough to transition to the patient load increase from residency to my clinic, or times when I was frustrated with my job. When these happened, it was even more stressful having the severity of the consequences of breaking a NHSC contract looming over me.

    However, I transitioned, the bumps have mostly evened out. I enjoy my job. Since I am salary, there isn't the pressure to produce and sell that I may feel in a corporate or private practice. Sure, the company always wants to see more patients, but my organization also does a good job of balancing the need for quality. I felt like I got a very competitive salary for a new graduate (even when compared to private practice or corporate dentistry). My benefits are awesome. The place I live in is a small town in upstate New York, but there is a college town 10 minutes away. I also have about $150k less debt than I would have. Now, if I transition into the loan repayment program, I get $50k at the beginning of another 2 year commitment, tax-free. So that's the equivalent of a $80-90k raise ($40-45k a year) for the next to years when you consider that it is tax-free, and the interest I will save up from paying off more loans.

    I did the scholarship for a 2-year commitment because I wasn't sure if I wanted to specialize, and I figured I could always go back after 2 years. It also gave me the easier option to get out after 2 years if I hated it. Now that I'm thinking about doing the LRP, it certainly would have been better to do the scholarship for all 4 years, but I think it was a reasonable price to pay to preserve the options of an exit after two years, and to allow a speciality residency after 2 years if I wanted to.

    As for my dealings with NHSC, things have been great. I got stonewalled before I applied when I tried to get details about whether health insurance was covered, or other detailed questions, and once during dental school I basically had to demand that they take back several thousand dollars they accidentally overpaid me. But other than that, things have been smooth. Website is great, my advisors have been great.

    So, in summary. Yes, the scholarship or loan repayment could result in a nightmarish depressing situation if you have an unforeseen event or get stuck in a terrible FQHC (although you can switch). As for some of the situations in this thread, I don't know how NHSC could hold you to penalties when no funds were even dispersed, and I imagine there certainly is the potential to get mired in some bureaucratic messes, but I would think that through persistence and perhaps some legal help some of those situations could be resolved. However, for the most part, if you really screen your job options, are pretty confident that you want to be in primary care or are okay with holding off a specialty for a couple years if you change your mind, it can be an awesome choice. It takes away a lot of the financial stress of loans, gives you a much quicker route to financial freedom, and can be an added perk onto what could be a great standalone job.

    Just wanted to throw out another perspective, since I saw a lot of negative posts before I applied, and not as many positive experiences like I've had, or the one other scholar I've known has had. Let me know if you have any questions.
     
  28. WGSgrad

    WGSgrad

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    I certainly understand that people who have had negative experiences are much more likely to share their story whether you are speaking of Amazon, Yelp, or SDN, so I certainly appreciate and understand you wanting to share an additional perspective.

    There were quite a few things that resonated for me about your experience but one in particular was the fact that you work in upstate New York. While I spent the past few years in major cities (Beijing, Philadelphia, etc.) I am originally from (and spent most of my life collectively) in upstate New York and would love to return. The considerably options that the NHSC program has in location is one of the reasons that this would be a much better fit for me than the HSPS program (which I also considered).

    As a non-traditional student (I will be 31 when I enter medical school, if accepted) I certainly have financial considerations that someone younger than me might not have about the financial burden associated with going to medical school (both the lost income from not working AND the inevitable student loans); although, perhaps I am fortunate in that I don't have a partner or children. I would very much like to work in an underserved areas (as a career) and was happy to see that OB/GYN (I would really like to principally work as a GYN) was a speciality covered by the NHSC scholarship.

    I think the way you went about it, making the two year commitment as opposed to four was certainly prudent and something I will certainly consider.

    Again, thanks for sharing.
     
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  29. DMG

    DMG 2+ Year Member

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  30. Doctor4Life1769

    Doctor4Life1769 **tr0llin, ridin dirty** 7+ Year Member

    Glad I'm not doing any of that.
     
  31. thatwouldbeanarchy

    thatwouldbeanarchy 2+ Year Member

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    Random question. Does anyone know who actually decides who gets accepted? I'm specifically interested in the Scholarship program. Just curious about who's going to be reading my essays. Doctors? Random government employees?
     
  32. smq123

    smq123 Roy Lichtenstein SDN Advisor SDN Administrator 10+ Year Member

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    Probably random government employees. Specifically, people who work for HRSA. Most likely not doctors.
     
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  33. thatwouldbeanarchy

    thatwouldbeanarchy 2+ Year Member

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    I kinda figured that. Thanks!
     
  34. Asyouwish1560

    Asyouwish1560

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  35. maug740

    maug740 5+ Year Member

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    Actually, I'm pretty sure that they employ medical professionals to help with the process. I'm at a Dental school, but one of my deans (who is a dentist) used to work in the public health sector and they still have him review Medical school students applications for the scholarship. So the people who read your applications do have experience in primary care and are looking for someone who they think would do well there.
     
  36. sabsaf123

    sabsaf123 2+ Year Member

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    Does doing NHSC impact where you can do your residency? Also can residency years count for the service years?
     
  37. sb247

    sb247 wait...you mean I got in? 5+ Year Member

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    Galt's Gulch
    residency does not count
     
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  38. smq123

    smq123 Roy Lichtenstein SDN Advisor SDN Administrator 10+ Year Member

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    As sb247 said, residency years don't count towards your service obligation.

    You can do residency wherever you want.
     
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  39. tesla motors ss

    tesla motors ss 2+ Year Member

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    Hey I am interested in OMS. And wondering if I would be able to do my residency before i start the commitment? Also how do i find the sites that are available for OMS.
     
  40. smq123

    smq123 Roy Lichtenstein SDN Advisor SDN Administrator 10+ Year Member

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    1. No. You can't. You have to do your commitment before doing an OMS residency.

    2. There aren't any. Again, the NHSC is only for general primary care and general dentistry.

    3. Please don't ask the same question multiple times.
     
  41. tesla motors ss

    tesla motors ss 2+ Year Member

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    1. thank you for the response.

    2. I didn't ask twice that was a follow up question in case the first question was yes.
     
  42. smq123

    smq123 Roy Lichtenstein SDN Advisor SDN Administrator 10+ Year Member

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    I mean, don't post the same question in multiple threads. Cross posting is against the terms of service.
     

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