what if I decide to leave

[uyentrang0820]

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So

 

[NavyFP]

I really need money for medical school, because money has been the big issue in my family so far. The question is after I sign up for military and finish all my duties with military ( maybe 3-4 years, I guess) After that, can I just leave and find a position in virtually any hospital in U.S.??????

When you have completed your military obligation, you are free to leave.

Can you go to any position in any hospital.....a qualified yes. (If you are qualified for the position)

Read more on the forum, taking HPSP only for the money is usually a bad idea.

 

[DeadCactus]

It amazes me how quickly people who have "money troubles" enter an investment that is almost guaranteed to lose them money. The vast majority of people are financially better off buying a few thousand lottery tickets to pay for medical school than taking HPSP to pay for it.

Now impatience toward financial gain is a different story, but not necessarily related to money troubles...

 

[Mirror Form]

It amazes me how quickly people who have "money troubles" enter an investment that is almost guaranteed to lose them money. The vast majority of people are financially better off buying a few thousand lottery tickets to pay for medical school than taking HPSP to pay for it.

Now impatience toward financial gain is a different story, but not necessarily related to money troubles...

Well depending on your specialty, if you go into med school and then a long residency, you are looking at 10 years of your family being dirt poor. So I can see why people with families who only have one parent working are often attracted to HPSP.

 

[The White Coat Investor]

I really need money for medical school, because money has been the big issue in my family so far. The question is after I sign up for military and finish all my duties with military ( maybe 3-4 years, I guess) After that, can I just leave and find a position in virtually any hospital in U.S.??????

Don't do it for the money. And expect the military to have some influence on your life for a minimum of 15 years. 4 years med school, 3 years residency, 4 years active duty, 4 years IRR.

 

[stonewall22]

It amazes me how quickly people who have "money troubles" enter an investment that is almost guaranteed to lose them money. The vast majority of people are financially better off buying a few thousand lottery tickets to pay for medical school than taking HPSP to pay for it.

Now impatience toward financial gain is a different story, but not necessarily related to money troubles...

You don't understand though...if you have a wife and kids, even if you make less in the long run, it does solve an immediate need for money. You can only take so much loan money and your family has to have a place to live and food to eat, so in that sense it meets an immediate need, and in the long run the money in the military is still adequate to live comfortably.

That being said, unless I have reasons other than money to take HPSP I won't take it, but that choice will probably mean that I won't get to be a doctor. 🙁

 

[DeadCactus]

Well depending on your specialty, if you go into med school and then a long residency, you are looking at 10 years of your family being dirt poor. So I can see why people with families who only have one parent working are often attracted to HPSP.

Maybe it's my school, but we get about the equivalent of the HPSP stipend in loans for our living expenses. While residency pay isn't what any of us would like for our 8 years of education, it's still more than 50% of US households are making.

The point is, it's reasonable to say "I want to make more money now and throughout training and will gladly give up a substantial amount in the long run for that comfort now." It's ridiculous to come and say "I have to take HPSP, because I don't have enough money to go to school."

Plenty of people make things work without signing up for a military obligation. They may not live as comfortably, but they're not starving...

 

[AF M4]

Delete.

 

[Droopy Snoopy]

Not so sure about the 4 years of IRR on the back end here. Unless you're USHUS or ROTC, you'd be done after your ADSC in the above scenario.

Once you're commissioned during med school, you're a 2Lt until graduation and slotted into a particular section of the IRR set up specifically for HPSPers. That's your IRR time. So say you commissioned for HPSP on July 1, 2010. That's an initial service commitment of 8 years, just like every other military contract. You spend 4 years in med school drawing pay as a 2Lt and doing the occasional ADT. This is your IRR time. Then you do your internship, which doesn't count towards your active duty commitment. Then you do 4 years of GMO payback for your ADSC. Meaning that you can cut all strings with the military as soon as your active duty payback is done, which in this case would be July 1, 2019.

(The internship squeezes an extra year out of you.)

Really? I mean it's great if that is true, but I was also under the impression that the IRR time followed the ADSC time for the 'typical' HPSPer.

 

[244913]

Your med school time does not count against your IRR time. In the above scenario the victim would be eligible for discharge in 2022.

 

[AF M4]

Nevermind.

 

[AF M4]

Delete.

 

[ieatpizza]

And yes there are a lot of random forum and blog posts out there saying that no, the med stud years do not count towards the IRR commitment despite the fact that as a med student you are in the IRR.
...
(God bless all the squirrelly pilots and commanders who've tried to snooker me by re-interpreting various military regulations. If there's one thing I'm sure to gain from my active duty time, it's an obsessive-compulsive need to read every inch of the fine print of anything I sign.)

I was pretty sure you were wrong, but looked it up to be sure. It's an Army Reg, but I assume the other services probably work the same way. See this document:
https://apps.mods.army.mil/MedEd/HPSP/Handbook/Chapter2.pdf

Key excerpt: "Reserve service obligation (RSO). Any remaining obligation that is not served on active duty is served in the Individual Ready Reserves (IRR), unless otherwise agreed upon by the participant and the Secretary of the Army. Participants cannot receive credit toward fulfilling the reserve portion of the contractual obligation for: reserve service as a participant in a civilian GPE; prior active duty or reserve service; the time spent in HPSP; reserve service performed prior to completion of the HPSP ADO (active duty obligation) or periods of active duty training as an HPSP participant. Time spent on active duty during participation in graduate professional education (GPE) (FYGME, AEGD 12 Month Program, internship, residency, fellowship), and time spent on active duty beyond the required ADO does count as credit toward fulfilling RSO."

Looks like your obsessive-compulsiveness missed this one.

 

[AF M4]

Nevermind.

 

[ClarkWGriswold]

Has an IRR physician ever been called up? Not talking about drilling reserve... as far as I know (which is just the navy side), no IRR have ever been activated. ever. I know that being on the IRR roster means you're on somebody's list somewhere, but I've been on IRR for 4 years now, and haven't done a f#cking thing. I have long hair and a beard.

Drilling reserve (aka active reserve) is probably a different story, but those guys are drawing a monthly paycheck from the military (and thus, playing russian roulette), where the IRR are not.

 

[Perrotfish]

It amazes me how quickly people who have "money troubles" enter an investment that is almost guaranteed to lose them money. The vast majority of people are financially better off buying a few thousand lottery tickets to pay for medical school than taking HPSP to pay for it.

I'm sorry, but the idea that HPSP is always a money hole is just wrong. I've run the numbers carefully, and even if you completely ignore the time value of money, going to my very expensive school and doing a military residency HPSP is a HUGE financial gain if I go into primary care and a slight gain if I go into the moderately paying specialties like EM. And, of course, ignoring the time value of money is not actually a reasonable way to do a financial analysis. That 20K bonus now is worth WAY more than 20K 8 years later.

I don't think that you should do it solely for the money, but the money ain't that bad.

 

[sethco]

So, I am sorry to tell you this AFM4, but you can look up these regs until you are blue in the face, it won't make any difference. When you apply for separation, they will see if you have any remaining service obligation (which starts the day you start active duty, not in med school) and will set that date.

IMHO, this is all an unnecessary discussion for two reasons.

First, as far as I know at least and as alluded to above, no doc in IRR has ever been called back to active duty. I have heard of stop lossing docs before, but once your separation date comes, stop loss no longer applies. Keep in mind you can be called back while on terminal leave, though.

Secondly, for those GMOs planning to hit the eject button and then go into a civilian residency, you may want to check out this reg.

http://www.dtic.mil/whs/directives/corres/pdf/121513p.pdf

and

http://biotech.law.lsu.edu/blaw/dodd/corres/pdf2/i121518p.pdf

In particular, look at 6.5.6 under exceptions. So it appears that while you are in a training program, you can't be recalled. Could be wrong, but that is the story that I am sticking to.

 

[DeadCactus]

I'm sorry, but the idea that HPSP is always a money hole is just wrong. I've run the numbers carefully, and even if you completely ignore the time value of money, going to my very expensive school and doing a military residency HPSP is a HUGE financial gain if I go into primary care and a slight gain if I go into the moderately paying specialties like EM. And, of course, ignoring the time value of money is not actually a reasonable way to do a financial analysis. That 20K bonus now is worth WAY more than 20K 8 years later.

I don't think that you should do it solely for the money, but the money ain't that bad.

It is not always a money hole, but more often than not it is. When it's not a loss, the gain certainly is nothing to throw a party over. The specialties have a pay differential high enough to make up money lost to loans and primary care has a lot of loan repayment options in exchange for things far more tolerable than a military contract.

I don't think HPSP is a bad program for everyone. I just think that anyone beginning the analysis from a financial stand-point is looking in the wrong place. The financial benefits are something you look at after deciding you want to do .mil med as a way to justify signing up now rather than after residency...

 

[AF M4]

So, I am sorry to tell you this AFM4, but you can look up these regs until you are blue in the face, it won't make any difference. When you apply for separation, they will see if you have any remaining service obligation (which starts the day you start active duty, not in med school) and will set that date.

IMHO, this is all an unnecessary discussion for two reasons.

First, as far as I know at least and as alluded to above, no doc in IRR has ever been called back to active duty. I have heard of stop lossing docs before, but once your separation date comes, stop loss no longer applies. Keep in mind you can be called back while on terminal leave, though.

Secondly, for those GMOs planning to hit the eject button and then go into a civilian residency, you may want to check out this reg.

http://www.dtic.mil/whs/directives/corres/pdf/121513p.pdf

and

http://biotech.law.lsu.edu/blaw/dodd/corres/pdf2/i121518p.pdf

In particular, look at 6.5.6 under exceptions. So it appears that while you are in a training program, you can't be recalled. Could be wrong, but that is the story that I am sticking to.

I appreciate it sethco. You know what? I just had a big brain freeze and am going to delete all the previous stuff. Forget I said anything. Have a good one.

 

[IlDestriero]

Has an IRR physician ever been called up? Not talking about drilling reserve... as far as I know (which is just the navy side), no IRR have ever been activated. ever. I know that being on the IRR roster means you're on somebody's list somewhere, but I've been on IRR for 4 years now, and haven't done a f#cking thing. I have long hair and a beard.

Drilling reserve (aka active reserve) is probably a different story, but those guys are drawing a monthly paycheck from the military (and thus, playing russian roulette), where the IRR are not.

Sorry to burst your bubble, but physicians were activated off of the IRR during Gulf war 2. That is when I was in, and I know it to be true. I don't know how many, but there were surgical subspecialists activated off the IRR. A PP cardiac surgeon was activated and after 6 months of filling in for a retired and unreplaced surgeon, he leveraged his home state Senator to help get him out. (successfully) A hand surgeon was also reactivated 6-12 months after he left active duty. His activation caused him extreme financial stress. I was there and knew the people involved. Anything can happen in the world at any time. If you are in the IRR, you better be financially ready to be reactivated for 6-12 months. You are NOT likely to be activated, there are USUALLY regular reserve people to activate, but not always. To think otherwise because it only affected a few known people almost a decade ago during a "real" war is your first step down the road to ruin. If North Korea invaded South Korea, how many troops would be deployed and activated immediately? All of them.

 

[NoMoreAMCAS]

I have a similar question. What if you're doing your time and half way through you decide you just want out? Do they stick you with some sort of crappy discharge like they do for enlisted people? Does it affect your ability to practice as a civilian?

I wouldn't do it. But I read about so many pissed of military doc's that it got me wondering what's keeping them there. Is it just them wanting to uphold a commitment they made, or is the possibly terrible military record a career ruiner?

 

[notdeadyet]

I've run the numbers carefully, and even if you completely ignore the time value of money, going to my very expensive school and doing a military residency HPSP is a HUGE financial gain if I go into primary care

True. HPSP pays for itself if you meet a few specific criteria: 1) you got to a very expensive school, 2) will be going into a low paying (<$150k/year) residency, 3) will not have to do a GMO tour.

and a slight gain if I go into the moderately paying specialties like EM.

Not what I found. With EM paying $220k/year, even going to an expensive school, HPSP operates at a loss. And given that at least two years in GMO land is virtually guaranteed in some services and still at least a 50/50 shot even in the Army, you're looking at a potential of really taking it in the shorts.

If you're interested in serving in the military anyway, HPSP is a nice financial incentive. But HPSP is a bad reason to join the military, since it may pay off financially or may end up costing you literally over a million dollars. And whether HPSP will pay for itself or cost you a couple houses depends on things that no first year medical student actually knows (What specialty will I do? Will it require a GMO tour? Or two? Or will I have to leave after four years as a GMO and compete with interns? Will my specialty training be good or sub-standard? Will I get called up off IRR? etc.).

 

[The White Coat Investor]

I have a similar question. What if you're doing your time and half way through you decide you just want out? Do they stick you with some sort of crappy discharge like they do for enlisted people? Does it affect your ability to practice as a civilian?

I wouldn't do it. But I read about so many pissed of military doc's that it got me wondering what's keeping them there. Is it just them wanting to uphold a commitment they made, or is the possibly terrible military record a career ruiner?

There is very little you can do that gets you out of the military yet doesn't affect your medical license/credentialing down the road. And those few things generally are so radical that most won't do it (change sexual orientation etc). Plus, keep in mind that most military docs are genuinely proud to serve and came into the service at least partially for the right reason. Just because they're getting out at the first opportunity doesn't make them bad officers, unpatriotic people etc. 4 years is a heck of a lot more than most people gave their country.

Also, most of us aren't so pissed off as we sound on this forum. We'd never sign up again, but there are still a few positive things about serving. We just feel it is important to convey some truths to those contemplating making the same decision (?error) that we did.

 

[Tenbusu]

Sorry to burst your bubble, but physicians were activated off of the IRR during Gulf war 2. That is when I was in, and I know it to be true. I don't know how many, but there were surgical subspecialists activated off the IRR. A PP cardiac surgeon was activated and after 6 months of filling in for a retired and unreplaced surgeon, he leveraged his home state Senator to help get him out. (successfully) A hand surgeon was also reactivated 6-12 months after he left active duty. His activation caused him extreme financial stress. I was there and knew the people involved. Anything can happen in the world at any time. If you are in the IRR, you better be financially ready to be reactivated for 6-12 months. You are NOT likely to be activated, there are USUALLY regular reserve people to activate, but not always. To think otherwise because it only affected a few known people almost a decade ago during a "real" war is your first step down the road to ruin. If North Korea invaded South Korea, how many troops would be deployed and activated immediately? All of them.

Technically, even civilians could be called up if we had another world war. IRR just means you are further up on the list. There is no escaping the federal government! But a more likely scenario than either of these would be nationalization of the health system, with ALL doctors working for the government all the time.