31 year old interested in career change. Researching HPSP

[NeedAnMD]

I work in IT right now. I run a small business. It's moderately successful, but that success isn't worth the hassle.

I graduated with a undergrad degree (B.A.) in Behavioral Sciences, so I realize I'll need postbac/premed. Recently, I've been looking into HPSP primarily as a means to finance it, but also because I've always had an itch to serve.

I went to see a recruiter today in order to get more information, but he just told me what he thought I wanted to hear (which I expected), and didn't seem to know much of anything about HPSP while pretending he did (which I didn't expect).

He basically just kept using the word "easy" in response to any of my questions, and in some instances I think he was misinforming me. The subject of how bad he was might make an interesting topic for another thread (I realize he is not representing my best interests, but there is some code of ethics for them, right?!?).

Here's how I'm understanding things so far, and I'd be much obliged if anyone could expound on this and tell me when I'm wrong.

1) Attempting to exchange service for financing my postbac/premed would likely delay matters significantly, and since I'm already a bit older than average and have some income, I may as well foot that bill myself.

2) My options are Army, Navy, or AF. I haven't yet had the time to check the differences, but I'd appreciate any input.

3) After four years of school, with my 1 weekend/month and 2 weeks/year of training, it's time for Internship and GME.

4) After graduation, I can begin my residency with the military, provided I accept my match.

5) If I don't like my match I can do PGY1, which _would_ also count for one year of residency. Then I can reapply for a match, and have a better shot of getting what I want than a comparable grad right out of med-school. Alternatively, I can ask for, but am not guaranteed, a deferral to complete my residency in the civilian sector.

6) Once my Internship and Residency are complete, I begin repaying my obligation to Uncle Sam. I would work full time wherever the military may need me, and I have little to no say as to where that is. Certain bases, especially those in the States, would allow me to bring my wife with me, but that would obviously require her to put her career as a property manager on hold. Since this is necessarily active duty, I would essentially do those 36 months straight.

7) Essentially, I can expect to spend about 7 years away from home and family after graduating med-school, assuming no civilian deferral for residency.

8) Since I'm currently interested in adult psychiatry or neuropsychiatry, I should not be overly worried about being matched with a GME too different from that (e.g. child psychiatry is still relevant enough, though maybe someone can come up with a worse scenario for argument's sake.)

9) An alternate path might be to take PGY1/Internship right out of school (which I don't believe is required for psychiatry, but I do believe it would count against my residency), and then do three years of GMO (where available), which would eliminate my obligation. I would then be left with three years of internship to do in the civilian sector, right?

I'm sure this is oversimplifying at best and wrong at times, so all input is much appreciated.

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[J-Rad]

First, start with a healthcare professions recruiter. Your general recruiter knows next to nothing about these programs. Your only question for them is the contact info for the above (or find one online)

I work in IT right now. I run a small business. It's moderately successful, but that success isn't worth the hassle.

I graduated with a undergrad degree (B.A.) in Behavioral Sciences, so I realize I'll need postbac/premed. Recently, I've been looking into HPSP primarily as a means to finance it, but also because I've always had an itch to serve.

I went to see a recruiter today in order to get more information, but he just told me what he thought I wanted to hear (which I expected), and didn't seem to know much of anything about HPSP while pretending he did (which I didn't expect).

He basically just kept using the word "easy" in response to any of my questions, and in some instances I think he was misinforming me. The subject of how bad he was might make an interesting topic for another thread (I realize he is not representing my best interests, but there is some code of ethics for them, right?!?).

Here's how I'm understanding things so far, and I'd be much obliged if anyone could expound on this and tell me when I'm wrong.

1) Attempting to exchange service for financing my postbac/premed would likely delay matters significantly, and since I'm already a bit older than average and have some income, I may as well foot that bill myself.

HPSP doesn't pay for post bacs/premed. HPSP for medical school is only for that, not for the schools to get you there.

2) My options are Army, Navy, or AF. I haven't yet had the time to check the differences, but I'd appreciate any input.

Look around here. Though after having experiences (ongoing) with all three services, I find that there aren't the great differences some would like to make it seem there are. That answer involves way more nuance than I care to get into right now, but you can get the basics looking around this forum.

3) After four years of school, with my 1 weekend/month and 2 weeks/year of training, it's time for Internship and GME.

You are not a traditional drilling reservist while in school on HPSP i.e. no "one weekend a month, two weeks a year". You are expected to accomplish one 45day active duty tour for training (ADT) per year on "scholarship". Typically you only spend about 30 day blocks of that time actively doing anything (indoc school, rotations [indoc schools may vary in time by service]) and are just getting paid for the reamining 15 days. Sometimes you are also paid those 45 days to just stay in place at school ("school tour"). O/w no weekend "drills".

After school, yes, internship +/- follow on residency.

4) After graduation, I can begin my residency with the military, provided I accept my match.

If you are selected, you have no option to refuse your match. It is your contractual obligation to take it.

5) If I don't like my match I can do PGY1, which _would_ also count for one year of residency. Then I can reapply for a match, and have a better shot of getting what I want than a comparable grad right out of med-school. Alternatively, I can ask for, but am not guaranteed, a deferral to complete my residency in the civilian sector.

The answer to this is far more nuanced. I also don't know the answer to this question: if you apply for a categorical residency (say 3 year internal medicine at military hospital) and are accepted but don't like the location and applied for a PGY 1 internship as a secondary choice, are you allowed to reject the IM residency and accept a prelim internship position? I honestly don;'t remember, but you'd probably be in a sucky position even if you could as your acceptance to the categorical residency would have pulled you from the internship selections. You'd be fighting for the scraps of what no one else wanted; at least to my undereducated perception. I do know, however, that if you like nothing in the .mil that you might be selected for, you are not allowed to reject it. You will be obligated to take it.

6) Once my Internship and Residency are complete, I begin repaying my obligation to Uncle Sam. I would work full time wherever the military may need me, and I have little to no say as to where that is. Certain bases, especially those in the States, would allow me to bring my wife with me, but that would obviously require her to put her career as a property manager on hold. Since this is necessarily active duty, I would essentially do those 36 months straight.

Huh? What 36 months?

7) Essentially, I can expect to spend about 7 years away from home and family after graduating med-school, assuming no civilian deferral for residency.

Where are you getting this?

8) Since I'm currently interested in adult psychiatry or neuropsychiatry, I should not be overly worried about being matched with a GME too different from that (e.g. child psychiatry is still relevant enough, though maybe someone can come up with a worse scenario for argument's sake.)

You can fail to be selected for the residency you want. But they can't force you to do a residency (or fellowship in the case of child psych) you didn't apply for.

9) An alternate path might be to take PGY1/Internship right out of school (which I don't believe is required for psychiatry, but I do believe it would count against my residency), and then do three years of GMO (where available), which would eliminate my obligation. I would then be left with three years of internship to do in the civilian sector, right?

The somewhat archaic term "internship" refers to the PGY1 in all programs (sometimes linked to, sometimes separate from follow on "residency years). Psych is always 4 years. The first year will often be colloquially called "internship". Same for peds (3 years), IM (3 years), FM (3 years), EM (3-4 years), surgery (5 years), etc. You can't do psych without the first year. You could do a PGY1 followed by GMO followed by GTFO and civilian residency. Some residencies will make you repeat some to all time as a PGY1 if you've been out in GMO land for too long.

I'm sure this is oversimplifying at best and wrong at times, so all input is much appreciated.

 

[NeedAnMD]

Thanks for the response.

First, start with a healthcare professions recruiter. Your general recruiter knows next to nothing about these programs. Your only question for them is the contact info for the above (or find one online)

I'm relieved to know that there are specialized recruiters for people like me.

1) Attempting to exchange service for financing my postbac/premed would likely delay matters significantly, and since I'm already a bit older than average and have some income, I may as well foot that bill myself.

HPSP doesn't pay for post bacs/premed. HPSP for medical school is only for that, not for the schools to get you there.

The recruiter I spoke with was referring to $5K a year tuition assistance. I didn't mean to imply it would come from HPSP, but it's neither here nor there, since I can afford undergrad courses at state college. It's cheap compared to med-school.

6) Once my Internship and Residency are complete, I begin repaying my obligation to Uncle Sam. I would work full time wherever the military may need me, and I have little to no say as to where that is. Certain bases, especially those in the States, would allow me to bring my wife with me, but that would obviously require her to put her career as a property manager on hold. Since this is necessarily active duty, I would essentially do those 36 months straight.

Huh? What 36 months?

After my meeting the recruiter pulled out his recruiter handbook (I noticed he'd been talking about some anesthesia and nursing program the entire time), and I pointed to the section on HPSP, and I'd swear I'd read 36 months there.

I went to Army HPSP website, and the following is more consistent with what I've read other places:

YOUR OBLIGATION

Your active duty service obligation to the U.S. Army is one year of service for every year you receive the scholarship. Your minimum obligation depends on your health care field. For example, the minimum obligation for medical students is two years. Dental, psychology, optometry and veterinary students are obligated to serve no fewer than three years. There is an additional obligation for residency and fellowship training.

That means 48 months, since med-school is four years. I assume the minimum of two years is if you go all Doogie Howser on it and finish early.

7) Essentially, I can expect to spend about 7 years away from home and family after graduating med-school, assuming no civilian deferral for residency.

Where are you getting this?

I took the erroneous figure of 36 months and added 48 months of residency, and came up with 7 years.

I'm sure I'll be given leaves and days off, but if I'm a resident, and then I'm active duty -- those being full-time jobs -- and since I don't get to pick where I go, then doesn't it follow that I'll be wherever the service wants me to be for the majority of 8 years?

If I'm interpreting correctly, the sentence reading "There is an additional obligation for residency and fellowship training" seems to imply the one-for-one of four years for the scholarship in addition to an obligation to complete my residency with the service.

Therefore, I'm coming up with 8 years away from home and family now. Don't get me wrong, I know there's no such thing as a free lunch, and I know military residents are better compensated than their civilian counterparts, but I may wanna make a baby with wifey at some point, and I'm wondering about where that fits. Am I understanding something wrong now?

Thanks again for the response. I'm continuing to research, but a little human interaction makes things much easier.

 

[NavyFP]

I'm sure I'll be given leaves and days off, but if I'm a resident, and then I'm active duty -- those being full-time jobs -- and since I don't get to pick where I go, then doesn't it follow that I'll be wherever the service wants me to be for the majority of 8 years?

If I'm interpreting correctly, the sentence reading "There is an additional obligation for residency and fellowship training" seems to imply the one-for-one of four years for the scholarship in addition to an obligation to complete my residency with the service.

Therefore, I'm coming up with 8 years away from home and family now. Don't get me wrong, I know there's no such thing as a free lunch, and I know military residents are better compensated than their civilian counterparts, but I may wanna make a baby with wifey at some point, and I'm wondering about where that fits. Am I understanding something wrong now?

You write this as if you expect the military not to move your family with you. While I certainly have spent time apart from family while deployed, they have never forced me to be apart from them. If your intent is to have your wife stay in one geographic location while you complete your time in the military, I would recommend rethinking your plan.

 

[NeedAnMD]

You write this as if you expect the military not to move your family with you. While I certainly have spent time apart from family while deployed, they have never forced me to be apart from them. If your intent is to have your wife stay in one geographic location while you complete your time in the military, I would recommend rethinking your plan.

Thanks for the reply. I didn't realize my wife could come with me on literally every deployment. My understanding was that in some situations she could, and in others she could not. Still, my family is larger than just one person. As far as rethinking the plan, I have to come up with one first

 

[orbitsurgMD]

Your wife cannot go with you on any deployment. You are confusing deployments, which are usually forward assignments to a theater of operations of whatever force you belong to, with operational assignments, which usually involve household relocation and the accompaniment of your family.

As an example, you might be assigned to a surface ship docked in Norfolk. You would live, usually with your family, somewhere near Norfolk. That is your duty station. As a doctor assigned to a ship, you will be taking part in workup operations and deployments away from Norfolk during your tour as a doctor on that ship. You might be deployed for six or more months to someplace with that ship. You go alone with your unit; your wife stays in Norfolk during that time.

 

[NeedAnMD]

Your wife cannot go with you on any deployment. You are confusing deployments, which are usually forward assignments to a theater of operations of whatever force you belong to, with operational assignments, which usually involve household relocation and the accompaniment of your family.

As an example, you might be assigned to a surface ship docked in Norfolk. You would live, usually with your family somewhere near Norfolk. That is your duty station. As a doctor assigned to a ship, you will be taking part in workup operations and deployments away from Norfolk during your tour as a doctor on that ship. You might be deployed for six or more months to someplace with that ship. You go alone with your unit; you wife stays in Norfolk during that time.

That makes a lot of sense and clears things up for me.

Thanks everyone for your responses.

Me and the boss (wife) have been talking, and surprisingly she's even more ambitious than me on this one. Not only is she also interested in a career change, but "military wife" sounds good to her. (I guess chicks really do love the uniform). A close friend of her's was an AF wife, and having spoken with that friend she knows what it entails. I think that on some level both of us just wanna get away from this life sooner rather than later.

On my part, I'm doing some simple arithmetic starting with 31, and I'm finding myself too old for postbac/premed + med school + an eight year commitment.

I still want to serve, but I'm hoping for something in between, and I can take a student loan for the remainder. I plan to take J-Rad's advice and speak with health professions recruiters.

In any case, I have to get through post-bac/premed first, so on Monday I'll be speaking with schools, and once I have that curriculum hammered out I'll speak with recruiters from Army/AF/Navy.

Thanks again.

 

[jabreal00]

I would think seriously about joining. I think I received pretty good training for residency and fellowship. I spent a year as staff after residency prior to fellowship. I am now finished with fellowship and a staff again. Both times I have gotten pretty sh*ty assignments. My wife is also an active duty physician and she's miserable. We both did HPSP because of the prospects of loans scared us when we signed (we did not know each other in prior to residency).

I guess the bottom line is if you are considering joining because you want to serve then it's a reasonably good reason to join. However, if it's for financial reasons, it's not worth it. You'll sell your freedom for 8 years, with the high potential for a really crappy assignment, deployments and time away from family. My friends who are civilians who are finished training with my same specialty seem extremely happy and are making more than enough money to easily pay off their loans.

There is nothing more depressing than being stuck in some crap city, low acuity volume for patients, and incompetent administration and command and feeling professionally unfulfilled.