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I've been meaning to write this entry for quite some time but have been too busy with residency to sit down and spell out why the TMS Program (Training in Medical Specialty) formerly called the MIT Program (Medical In Training) works out to be a financial loss for anyone who joins. I will tell you that my experience is specific to the Navy, so those considering other branches should read their specific instructions very carefully before they sign on the dotted line. The bottom line for anyone though is that by incurring the 1:1 or 2:1 commitment the branches are now requiring for receiving money during residency, you are almost certainly better off waiting and joining the reserves when you are done with training. I'll explain why…
I am former HPSP, active duty for four years, currently serving out the remainder of my IRR commitment as a drilling reservist under the TMS program. I joined when it was truly a non-commitment program and, so long as you didn't take any bonuses, you could quit at any time. That has since changed and the Navy now requires a 1:1 or 2:1 payback after you are done with your residency depending on if you get drill pay (roughly $500/month) or the stipend (roughly $2000/month). With my program, I have been able to drill when I can and use my lectures during residency as my "drill time" to supplement my drills on the months I can't drill with my unit. Most people in the TMS program "drill" twice per year when they show up and run a PFT, and use their lectures during residency as their monthly drills. All in all, I average somewhere around $500/month after taxes. The money has come in handy during residency, I will admit. I also use my GI Bill to help augment the paltry civilian resident salary. Sounds great, right?
Even under the non-commitment program that I fall under, the program is still a financial mistake. Had I known then what I know now, I would have never signed up for this program. Keep in mind that my experiences with the Navy have been largely positive and I am one of the few on this site that would still do the HPSP scholarship all over again. The TMS program, however, is a disaster.
There are two incentive programs that are currently offered by the Navy that make the TMS program a financial mistake as it is currently written: one is the Critical Wartime Specialties Bonus Program (CWS) and the other is the Loan Repayment Program (LRP). All of the branches offer some version of these two programs and some of the branches let you use both of these programs during your career as a reservist (one after another). Recruiters don't want you to know about these programs because if you knew about them, no one would ever join the TMS program.
One assumption that my rationale depends on is that most of us are training in a specialty on the Critical Wartime Specialty list. Most specialties are on this list since the military can't keep doctors in any specialty. If you're not doing a residency in a CWS, then my logic may not apply. Each service has a slightly different list of CWS approved specialties (for example, flight surgery is considered a CWS in the Air Force, but not in the Navy). My logic also relies on the assumption that the following bonus programs will still exist in their current state when you are done with your residency (which may be a big assumption right now).
The Loan Repayment Program can be taken after completing 2 PGY years in a CWS approved specialty. Under this program, after completing your PGY-2 year, you are eligible for $20,000 per year up to a max of $50,000 for a 1:1 year commitment in the reserves. Payment to your loan is made at the end of the year after you have shown evidence of a "good year" in the reserves. So this is up to $50k tax free and paid directly to your loans for a 3 year commitment in the reserves after residency.
The CWS Bonus program entitles you to $25k per year for a 1:1 commitment for a max of 3 years. Thus, another $75k you are entitled to for another 3 year commitment. This money is taxable income.
The catch is that both of these programs - in the Navy - require you to not having been in the drilling reserves for the past 12 months. This varies from service to service, but the intention here is that they are accession bonuses, not retention bonuses. So by being in the TMS program during residency, I have now made myself ineligible to receive these incentives. This is something that my recruiter failed to explain to me when I was signing up for the TMS program. Unless I get out of the reserves for 12 months and then rejoin, I am unable to collect these bonuses. So the TMS program has made me ineligible for up to $125k in bonuses.
In any case, if you do the math for someone who is considering the current programs, it works out like this for the CWS program:
Option 1) Take drill pay only for a 1:1 commitment: For a 3 year residency you make approximately $6k after taxes, approximately $18k over the course of your residency. You now cannot take the CWS bonus of $75k until you have paid back 3 years in the reserves plus getting out for a year and rejoining. So you have pushed back the possibility of $25k per year until 4 years after you have completed your residency. You have traded $75k before taxes for roughly $18k after taxes, for the same amount of commitment.
Option 2)Take the Stipend pay for a 2:1 commitment: 3 year residency = $72k over 3 years with a commitment of 6 years of reserve time. Factor in the 12 months you have to be out of the reserves before you can rejoin in order to collect the CWS, assuming it even exists then, and you've now pushed off the $75k CWS bonus for 7 years after you finish residency in order to collect the money during residency. The reason this option makes little sense, however, is that you are incurring twice the commitment for the roughly same amount of money. And remember that once you owe the military time, you are automatically ineligible for any other bonuses that may arise until you have paid your time back.
Additionally, if you are in a branch that allows you to take the LRP program, pay your 3 years back, and then join the CWS program, you can add another $50k to the money you have made yourself ineligible for by being in the TMS program.
Also keep in mind that the "drill pay" you collect during residency is not as straight forward as it sounds. I have to keep meticulous records of when I drill and what lectures I am submitting for drill pay. It inevitably gets screwed up, paperwork gets lost, and I have to make phone calls, resubmit forms, etc. It isn't automatic and it isn't without its headaches. Keep in mind that no admin office knows what to do with a reservist who claims they don't have to drill but they still get to collect drill pay just because they are a doctor. To an enlisted admin person, this makes no sense and leads to an endless supply of headaches and explanations.
Sorry that this is so long, but the TMS program is complicated and no one ever explained this stuff to me. Unfortunately, I have had to learn things the hard way and I would hate for anyone to repeat my mistakes. I don't claim to be an expert, so if anyone has different information, please chime in.
Lastly, keep in mind that for those thinking of entering a private practice after residency, your reserve commitment will likely not be looked upon favorably if the partners know you may have to leave the practice for up to a year at a moment's notice. They probably won't tell you this during the interview, but no one wants an employee that may take off at a moment's notice, leaving a void for the other group members to fill. Just something to think about. And when you sign on that line with the military, you will make this a very real issue for yourself once you are done with residency.
In any case, my advice: Stay away from the TMS/Stipend/MIT programs and join the reserves once you are done with your residency. If you still want to serve your country then, you will likely be able to collect more money for less commitment. Tough it out during residency. Use your GI Bill if you have it, take out loans, etc. Stay away from this program. It may look good in the short term, but it is a disaster on many levels over the long haul. I strongly believe the Navy should do away with this mess of a program.
Hope this helps.
NavyFlightSrgn
I am former HPSP, active duty for four years, currently serving out the remainder of my IRR commitment as a drilling reservist under the TMS program. I joined when it was truly a non-commitment program and, so long as you didn't take any bonuses, you could quit at any time. That has since changed and the Navy now requires a 1:1 or 2:1 payback after you are done with your residency depending on if you get drill pay (roughly $500/month) or the stipend (roughly $2000/month). With my program, I have been able to drill when I can and use my lectures during residency as my "drill time" to supplement my drills on the months I can't drill with my unit. Most people in the TMS program "drill" twice per year when they show up and run a PFT, and use their lectures during residency as their monthly drills. All in all, I average somewhere around $500/month after taxes. The money has come in handy during residency, I will admit. I also use my GI Bill to help augment the paltry civilian resident salary. Sounds great, right?
Even under the non-commitment program that I fall under, the program is still a financial mistake. Had I known then what I know now, I would have never signed up for this program. Keep in mind that my experiences with the Navy have been largely positive and I am one of the few on this site that would still do the HPSP scholarship all over again. The TMS program, however, is a disaster.
There are two incentive programs that are currently offered by the Navy that make the TMS program a financial mistake as it is currently written: one is the Critical Wartime Specialties Bonus Program (CWS) and the other is the Loan Repayment Program (LRP). All of the branches offer some version of these two programs and some of the branches let you use both of these programs during your career as a reservist (one after another). Recruiters don't want you to know about these programs because if you knew about them, no one would ever join the TMS program.
One assumption that my rationale depends on is that most of us are training in a specialty on the Critical Wartime Specialty list. Most specialties are on this list since the military can't keep doctors in any specialty. If you're not doing a residency in a CWS, then my logic may not apply. Each service has a slightly different list of CWS approved specialties (for example, flight surgery is considered a CWS in the Air Force, but not in the Navy). My logic also relies on the assumption that the following bonus programs will still exist in their current state when you are done with your residency (which may be a big assumption right now).
The Loan Repayment Program can be taken after completing 2 PGY years in a CWS approved specialty. Under this program, after completing your PGY-2 year, you are eligible for $20,000 per year up to a max of $50,000 for a 1:1 year commitment in the reserves. Payment to your loan is made at the end of the year after you have shown evidence of a "good year" in the reserves. So this is up to $50k tax free and paid directly to your loans for a 3 year commitment in the reserves after residency.
The CWS Bonus program entitles you to $25k per year for a 1:1 commitment for a max of 3 years. Thus, another $75k you are entitled to for another 3 year commitment. This money is taxable income.
The catch is that both of these programs - in the Navy - require you to not having been in the drilling reserves for the past 12 months. This varies from service to service, but the intention here is that they are accession bonuses, not retention bonuses. So by being in the TMS program during residency, I have now made myself ineligible to receive these incentives. This is something that my recruiter failed to explain to me when I was signing up for the TMS program. Unless I get out of the reserves for 12 months and then rejoin, I am unable to collect these bonuses. So the TMS program has made me ineligible for up to $125k in bonuses.
In any case, if you do the math for someone who is considering the current programs, it works out like this for the CWS program:
Option 1) Take drill pay only for a 1:1 commitment: For a 3 year residency you make approximately $6k after taxes, approximately $18k over the course of your residency. You now cannot take the CWS bonus of $75k until you have paid back 3 years in the reserves plus getting out for a year and rejoining. So you have pushed back the possibility of $25k per year until 4 years after you have completed your residency. You have traded $75k before taxes for roughly $18k after taxes, for the same amount of commitment.
Option 2)Take the Stipend pay for a 2:1 commitment: 3 year residency = $72k over 3 years with a commitment of 6 years of reserve time. Factor in the 12 months you have to be out of the reserves before you can rejoin in order to collect the CWS, assuming it even exists then, and you've now pushed off the $75k CWS bonus for 7 years after you finish residency in order to collect the money during residency. The reason this option makes little sense, however, is that you are incurring twice the commitment for the roughly same amount of money. And remember that once you owe the military time, you are automatically ineligible for any other bonuses that may arise until you have paid your time back.
Additionally, if you are in a branch that allows you to take the LRP program, pay your 3 years back, and then join the CWS program, you can add another $50k to the money you have made yourself ineligible for by being in the TMS program.
Also keep in mind that the "drill pay" you collect during residency is not as straight forward as it sounds. I have to keep meticulous records of when I drill and what lectures I am submitting for drill pay. It inevitably gets screwed up, paperwork gets lost, and I have to make phone calls, resubmit forms, etc. It isn't automatic and it isn't without its headaches. Keep in mind that no admin office knows what to do with a reservist who claims they don't have to drill but they still get to collect drill pay just because they are a doctor. To an enlisted admin person, this makes no sense and leads to an endless supply of headaches and explanations.
Sorry that this is so long, but the TMS program is complicated and no one ever explained this stuff to me. Unfortunately, I have had to learn things the hard way and I would hate for anyone to repeat my mistakes. I don't claim to be an expert, so if anyone has different information, please chime in.
Lastly, keep in mind that for those thinking of entering a private practice after residency, your reserve commitment will likely not be looked upon favorably if the partners know you may have to leave the practice for up to a year at a moment's notice. They probably won't tell you this during the interview, but no one wants an employee that may take off at a moment's notice, leaving a void for the other group members to fill. Just something to think about. And when you sign on that line with the military, you will make this a very real issue for yourself once you are done with residency.
In any case, my advice: Stay away from the TMS/Stipend/MIT programs and join the reserves once you are done with your residency. If you still want to serve your country then, you will likely be able to collect more money for less commitment. Tough it out during residency. Use your GI Bill if you have it, take out loans, etc. Stay away from this program. It may look good in the short term, but it is a disaster on many levels over the long haul. I strongly believe the Navy should do away with this mess of a program.
Hope this helps.
NavyFlightSrgn
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