Conflicted about HPSP

[futuredoc0307]

I am interested in emergency medicine/surgery. so I know I can pursue those specialities with the HPSP. However, I am concerned about my career after I fulfil the 4 years. Will there be limitations when I return to civilian healthcare? will I be at advantage/disadvantage? Are there any strings attached to this other than the fact that I have to commit 4 years? for example, will I be completely free from military service or will i be on reserve afterwards? I want this program because of the financial perks. I understand that it can affect my life greatly in terms of family. However, it would be nice to study medicine while not thinking of my debt 24/7 or worrying about if i met my weekly budget to go out for a drink or get lunch twice. I feel like eliminating this kind of stress during medical school would greatly impact the experience of those 4 years.

Any personal experience? which branch of the military did you do it with?

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[daw05]

@Armyhealth is a recruiter on these boards that may be able to answer some of your questions more clearly.

I'm active duty now, and am looking to go either USUHS or HPSP. From my research so far (and all of my shadowing with emergency medicine), some things to consider:

During medical school, you'll get a stipend, and then full active duty pay for about 45 days each summer while you do training. You'll also get a monthly stipend and a bonus of some kind (about $20k). I don't know your personal circumstances, but it is certainly a good amount of money for someone who is single.

Absolutely no barrier to entry in civilian market for military EM. In fact, most of them moonlight at a civilian hospital to keep trauma skills up. Usually do about 5 extra shifts a month.

Keep in mind that you will owe your time AFTER residency, so your commitment is 4 years plus. If you're doing surgery, that means you're in the military 10 years. EM means 7.

A positive is residency pay. You will be making much more than your peers for the 3 years of residency. You probably lose out on the back end of your service time, but you also won't have any debt.

As an officer, you are never *fully* out until you are 65. When you leave service, you technically go on Individual Ready Reserve. That means if WW3 happens, you're getting called before the country institutes a draft. Otherwise, no actual commitment.

 

[futuredoc0307]

@Armyhealth

Keep in mind that you will owe your time AFTER residency, so your commitment is 4 years plus. If you're doing surgery, that means you're in the military 10 years. EM means 7.
.

do I have the option of matching in civilian over military?

 

[Detective SnowBucket]

@Armyhealth is a recruiter on these boards that may be able to answer some of your questions more clearly.

I'm active duty now, and am looking to go either USUHS or HPSP. From my research so far (and all of my shadowing with emergency medicine), some things to consider:

During medical school, you'll get a stipend, and then full active duty pay for about 45 days each summer while you do training. You'll also get a monthly stipend and a bonus of some kind (about $20k). I don't know your personal circumstances, but it is certainly a good amount of money for someone who is single.

Absolutely no barrier to entry in civilian market for military EM. In fact, most of them moonlight at a civilian hospital to keep trauma skills up. Usually do about 5 extra shifts a month.

Keep in mind that you will owe your time AFTER residency, so your commitment is 4 years plus. If you're doing surgery, that means you're in the military 10 years. EM means 7.

A positive is residency pay. You will be making much more than your peers for the 3 years of residency. You probably lose out on the back end of your service time, but you also won't have any debt.

As an officer, you are never *fully* out until you are 65. When you leave service, you technically go on Individual Ready Reserve. That means if WW3 happens, you're getting called before the country institutes a draft. Otherwise, no actual commitment.

what do you mean in for 10 years? Even if it is a long residency (I believe they add some time for that) its not over 5 maybe 6, are you including time in residency in that 10?

 

[Medic741]

do I have the option of matching in civilian over military?

If you do Army a strong NO. If you do EM and aren’t willing to put your life on hold to do a TY, and if you think you might struggle to compete against prior service SF medics who wanted to become docs for those Very few EM spots GL with an Army EM goal.

Slightly salty about that as I learned that reality at our training this summer.

 

[daw05]

do I have the option of matching in civilian over military?

I think you go through the military match first, but there are limited opportunities to do the civilian match

 

[daw05]

what do you mean in for 10 years? Even if it is a long residency (I believe they add some time for that) its not over 5 maybe 6, are you including time in residency in that 10?

HPSP has a 4 year obligation that begins following completion of residency. If you do a surgery residency that lasts 6 years, that makes 10 years total minimum time in the military.

On the same note, a 3 year EM residency followed by 4 year obligation equals 7 years in military

 

[Medic741]

HPSP has a 4 year obligation that begins following completion of residency. If you do a surgery residency that lasts 6 years, that makes 10 years total minimum time in the military.

On the same note, a 3 year EM residency followed by 4 year obligation equals 7 years in military

This is dead wrong.

You incur 4 years HPSP during MED school, and then XX period during residency. You serve both contracts concurrently, not consecutively.

 

[daw05]

This is dead wrong.

You incur 4 years HPSP during MED school, and then XX period during residency. You serve both contracts concurrently, not consecutively.

See page 18, which discusses service obligations in terms of USUHS, but the same applies to HPSP. See page 24 for a chart concerning both options. Regardless, your service obligation is not paid back until after graduate medical education, i.e. residency.
On page 24, it does indicate that if you have a longer residency that you have a longer obligation for HPSP than only a 3 year residency.

https://www.usuhs.edu/sites/default/files/media/medschool/pdf/whatyouneedtoknow.pdf

 

[Detective SnowBucket]

See page 18, which discusses service obligations in terms of USUHS, but the same applies to HPSP. See page 24 for a chart concerning both options. Regardless, your service obligation is not paid back until after graduate medical education, i.e. residency.
On page 24, it does indicate that if you have a longer residency that you have a longer obligation for HPSP than only a 3 year residency.

https://www.usuhs.edu/sites/default/files/media/medschool/pdf/whatyouneedtoknow.pdf

However, it seems you can get a jump on payback before residency doing a GMO tour.

 

[futuredoc0307]

so i take from this that i would most likely be forced into military match?

 

[Matthew9Thirtyfive]

This is dead wrong.

You incur 4 years HPSP during MED school, and then XX period during residency. You serve both contracts concurrently, not consecutively.

Not sure if this is what you're trying to say, but you serve your residency obligation and HPSP obligation at the same time (concurrently); however, you do not start paying them back until after residency. So if you do a 3-year EM residency after med school, you would pay back 4 years after your 3 year residency.

 

[Matthew9Thirtyfive]

so i take from this that i would most likely be forced into military match?

You are required to participate in the military match. HPSP students are also required to register for ERAS and sign up for the civilian match, as military residency spots are competitive, and USUHS students are legally and contractually guaranteed military spots. Whether the branch of service you join allows you to go into the civilian match in the event that you do not match military is another thing, and the branches differ on how often they do that.

 

[futuredoc0307]

You are required to participate in the military match. HPSP students are also required to register for ERAS and sign up for the civilian match, as military residency spots are competitive, and USUHS students are legally and contractually guaranteed military spots. Whether the branch of service you join allows you to go into the civilian match in the event that you do not match military is another thing, and the branches differ on how often they do that.

thank you for the input. But I am a bit lost in the midst of all the abbreviations. What is the USUHS?

 

[Matthew9Thirtyfive]

thank you for the input. But I am a bit lost in the midst of all the abbreviations. What is the USUHS?

Uniformed Services University of the Health Sciences. It is home to the Hebert SOM, the military medical school.

 

[Detective SnowBucket]

Not sure if this is what you're trying to say, but you serve your residency obligation and HPSP obligation at the same time (concurrently); however, you do not start paying them back until after residency. So if you do a 3-year EM residency after med school, you would pay back 4 years after your 3 year residency.

Do you know at what point (how long of a residency) they add on time to the pay-back (like 90% certain I heard this)? Also, is there any way for them to increase your payback time otherwise, like will they be mean if you do get to do a civilian residency, go to an expensive med school etc..?

 

[Matthew9Thirtyfive]

Do you know at what point (how long of a residency) they add on time to the pay-back (like 90% certain I heard this)? Also, is there any way for them to increase your payback time otherwise, like will they be mean if you do get to do a civilian residency, go to an expensive med school etc..?

You incur time for each year of residency (I think it’s actually 6 months for every 6 months of training), except for internship which is neutral (in the Navy at least). You pay this back concurrently with your 4 year HPSP obligation (or 3 years if you take a 3 year scholarship).

You do not incur more time if your school is really expensive lol.

Technically the obligation is 8 years, it’s just that only 4 or however much active duty time you owe is active. The rest is IRR which basically means you’re just on the hook if they want to activate you. I have seen people get extended involuntarily, but I’ve never seen someone go onto IRR and then get recalled in the Navy. It probably does happen occasionally, though probably less now.

 

[Perrotfish]

Do you know at what point (how long of a residency) they add on time to the pay-back (like 90% certain I heard this)? Also, is there any way for them to increase your payback time otherwise, like will they be mean if you do get to do a civilian residency, go to an expensive med school etc..?

The rule is that the time you owe coming out of residency is equal to either the length of time you owed going in to residency, or the length of the residency (excluding Intern year), whichever is more.

So if you take a 4 year scholarship, do a 2 year Peds residency (+Peds intern year) 4> 2 and you owe 4 years. If you take a 4 year scholarship and do a 6 year neuro surgery residency (+neurosurgeon intern year) 6> 4, you owe 6 years.

Lots more to know about HPSP, but the most important thing to understand is that you can not get out of this obligation once you sign, no matter how little you like the deal. So do lots of reading .

 

[Perrotfish]

BTW the rule is different for fellowships. The amount of time you owe after a fellowship is the amount of time you owed going in plus the length of the fellowship. So if you owe 4 years at the end of a Pediatric residency, and then do a 3 year pediatric pulmonology fellowship, you finish fellowship owing 7 years.

 

[Matthew9Thirtyfive]

BTW the rule is different for fellowships. The amount of time you owe after a fellowship is the amount of time you owed going in plus the length of the fellowship. So if you owe 4 years at the end of a Pediatric residency, and then do a 3 year pediatric pulmonology fellowship, you finish fellowship owing 7 years.

Fellowship just gets tacked onto whatever you owe, right? Like say you finish a 3 year peds residency and owe 4 years, then you do a 3 year utilization tour, so you'd owe 1 year left. If you go do a 3 year fellowship, at the end of that you'll owe 4 years (1+3)?

 

[Perrotfish]

Fellowship just gets tacked onto whatever you owe, right? Like say you finish a 3 year peds residency and owe 4 years, then you do a 3 year utilization tour, so you'd owe 1 year left. If you go do a 3 year fellowship, at the end of that you'll owe 4 years (1+3)?

That is my understanding, yes. Please double check me, I haven't done a fellowship.

 

[Detective SnowBucket]

I believe I had heard that about fellowship too, but, how much less competitive would you be trying to get into a fellowship after payback was completed?

 

[Matthew9Thirtyfive]

That is my understanding, yes. Please double check me, I haven't done a fellowship.

It appears you are correct. Per DoDI 6000.13 4.d.2.e., an active duty obligation cannot be served concurrently with any other active duty obligation incurred as the result of GME.

www.esd.whs.mil/Portals/54/Documents/DD/issuances/dodi/600013p.pdf#page=16

 

[Perrotfish]

I believe I had heard that about fellowship too, but, how much less competitive would you be trying to get into a fellowship after payback was completed?

Are you asking about getting a fellowship through the military or after getting out of the military?

 

[Armyhealth]

do I have the option of matching in civilian over military?

Most likely no, army allows civilian residency sometimes but it is a case by case scenario and pretty rare these days.

 

[Detective SnowBucket]

Are you asking about getting a fellowship through the military or after getting out of the military?

I guess outside of military because it would be once payback is completed.

 

[Perrotfish]

I guess outside of military because it would be once payback is completed.

Anecdotally applicants who have completed their HPSP obligation and then apply to fellowship seem to do well. I have no data to support that, though.