HPSP help

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Tim722

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Hello All,

This is my first time posting. Just wanted some input as I have lurked and read most of the posts on this page and have also tried to talk to as many current physicians in the military as possible. So a little back story I was admitted into an osteopathic school last year but ended up deferring a year for some personal reasons during that time I retook the MCAT, and published twice and figured I would apply next cycle as well in hopes to be admitted to schools closer. I was fully committed to military medicine as I looked at the pros and cons and looked at the military as a place I could have a chance to match into specialties that would be really hard in the civilian side and the uncertainty of how the (AOA ACGME) merger was going to affect osteopathic physicians looking into competitive specialties. So fast forward a year I have been accepted into UCLA DGSOM and don't know what I should do about taking HPSP (AF by the way). I wanted to serve before I went to college but didn't because of the career I wanted I figured it would put me really far behind.

Financially I will most likely graduate at the normal in debt range 200-250k if I took out the loans which right now is definitely terrifying. I just am having trouble deciding which way is better financially and career wise. As you can scour the forum reading about how these superstars are considering a research year with there 245 step score in order to make sure they match.

Really would love some constructive input.

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Hello All,

This is my first time posting. Just wanted some input as I have lurked and read most of the posts on this page and have also tried to talk to as many current physicians in the military as possible. So a little back story I was admitted into an osteopathic school last year but ended up deferring a year for some personal reasons during that time I retook the MCAT, and published twice and figured I would apply next cycle as well in hopes to be admitted to schools closer. I was fully committed to military medicine as I looked at the pros and cons and looked at the military as a place I could have a chance to match into specialties that would be really hard in the civilian side and the uncertainty of how the (AOA ACGME) merger was going to affect osteopathic physicians looking into competitive specialties. So fast forward a year I have been accepted into UCLA DGSOM and don't know what I should do about taking HPSP (AF by the way). I wanted to serve before I went to college but didn't because of the career I wanted I figured it would put me really far behind.

Financially I will most likely graduate at the normal in debt range 200-250k if I took out the loans which right now is definitely terrifying. I just am having trouble deciding which way is better financially and career wise. As you can scour the forum reading about how these superstars are considering a research year with there 245 step score in order to make sure they match.

Really would love some constructive input.

200-250 in debt is nothing. Take out the loan. You can repay those loans in 3 years easily.
 
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Congrats on getting into UCLA. Take the loans and don't look back.
Thank you I appreciate that. I know that's what I should do I just hope I don't look back on military medicine in a what if? I know that sounds weird but I really wanted to do my part but was looking for reassurance in my decisions not to join I guess.
 
200-250 in debt is nothing. Take out the loan. You can repay those loans in 3 years easily.
Do you really think that's the case? For a specialist yea I could see that but for generalists it seems like it would be pretty rough? Of course in my postion it seems like its near impossible to pay those off.
 
Do you really think that's the case? For a specialist yea I could see that but for generalists it seems like it would be pretty rough? Of course in my postion it seems like its near impossible to pay those off.

Do you know how much FM and IM hospitalists make nowadays?
 
Do you know how much FM and IM hospitalists make nowadays?
Well looking at the latest medscape data it looked to be abut 180-200? I just am niave when it comes to the ins and out of malpractice etc so I am not sure what the net would be for an internist or FM in a state like ca.
 
Well looking at the latest medscape data it looked to be abut 180-200? I just am niave when it comes to the ins and out of malpractice etc so I am not sure what the net would be for an internist or FM in a state like ca.

That's 180-200K for a highly desirable place like downtown LA. If you are willing to practice other parts of the country, you should easily net $250-280K a year. When I mean other parts of the country, I'm not talking about dumps in the middle of nowhere.
 
have also tried to talk to as many current physicians in the military as possible.

how many was that? what was their take?

Under any circumstances do you recommend HPSP/milmed?

just off the top of my head:

1) prior service who already have several years in and know what they are getting into

2) someone who knows they want to do primary care who are going to an expensive/private medschool and can burn their time off (one duty station post residency) and get out, who have an accurate idea of what may happen during their payback.

--your friendly neighborhood information is power caveman
 
Under any circumstances do you recommend HPSP/milmed?
To piggyback on what Homunculus said, there should also be a deep and sincere desire to serve your country, and do so as a soldier. There will be sacrifices on your part and if there is not some fundamental belief that you are doing what you desire you will make an already difficult situation worse.
 
That's 180-200K for a highly desirable place like downtown LA. If you are willing to practice other parts of the country, you should easily net $250-280K a year. When I mean other parts of the country, I'm not talking about dumps in the middle of nowhere.
Yea I have heard that pay can differ drastically. Well that does make a difference big time.
 
how many was that? what was their take?



just off the top of my head:

1) prior service who already have several years in and know what they are getting into

2) someone who knows they want to do primary care who are going to an expensive/private medschool and can burn their time off (one duty station post residency) and get out, who have an accurate idea of what may happen during their payback.

--your friendly neighborhood information is power caveman

1. Well, in that case I have only talked to a couple person that hs been in for 7+ years. Granted one works for USUHS and is obviously going to be biased. The other, did a GMO tour got out did a gas residency and then rejoined. He Is actually finishing up in the next couple days. Both highly recommend service as a physician. The others I have talked to are from my alma matter but they are just finishing residency.


2. I dont know what I want to do yet. So yes to me this has been the biggest drawback from pulling the trigger on milmed as I do know that odds are good if you want to do Peds,Gas,and FM/IM. None of my interests really line up with those. Truthfully surgery would be my main persuit if I went in becuase I would want to have a bigger impact during deployments.
 
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To piggyback on what Homunculus said, there should also be a deep and sincere desire to serve your country, and do so as a soldier. There will be sacrifices on your part and if there is not some fundamental belief that you are doing what you desire you will make an already difficult situation worse.
Thanks for the reply, I have poured over your posts for the past few months. Truthfully, I would love to serve, but I dont know if my will to serve overcomes my more selfish career ambitions. There is always FAP I suppose. Just the whole the AF increses your chance to match pitch the recruiter has given me has got my head all gumbled lol.
 
That's 180-200K for a highly desirable place like downtown LA. If you are willing to practice other parts of the country, you should easily net $250-280K a year. When I mean other parts of the country, I'm not talking about dumps in the middle of nowhere.
Would this be right agfter residency or 5 years post residency.
 
Would this be right agfter residency or 5 years post residency.

Most of the quotes that I've heard for small towns 1-1.5 hrs from a major city or smaller cities are around 220-240 K in the first 1-3 years. As you improve your efficiency, a lot of people push it to 280-320K/yr. The bottom is that your salary is closely tied to the number of pts/day *10. For example, let's say that you're seeing about 4 pts/hr for a day work of about 32 pts. You can expect your income to be around 300-340K/yr.

Remember that the salaries also come from academics who makes about 20-30% from the average of the clinicians. Like I said, a total loan of 200-250K out of med school is very doable. Finally, if you are going into primary care, there are thousands of programs out there that will forgive your debt.
 
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Thanks for the reply, I have poured over your posts for the past few months. Truthfully, I would love to serve, but I dont know if my will to serve overcomes my more selfish career ambitions. There is always FAP I suppose. Just the whole the AF increses your chance to match pitch the recruiter has given me has got my head all gumbled lol.
There's nothing wrong or selfish about wanting to put your medical career first. This is your career, and it will effect your family and your life. You have to approach HPSP/USUHS with the understanding that there will be payback involved for the benefits of military commitment. Knowing as much as possible about what the benefits and drawbacks are can help with this decision.

The military match is subject to so much variability that one cannot accurately say whether it is easier or harder as compared to the civilian match. The numbers are small and the needs of the military change. Don't cloud your vision with this too much. If you truly want to serve, try to extrapolate what your career would be like if nothing went your way: meaning does the desire to serve trump the thought of a transitional year followed by a 4 year GMO in a miserable location? How will this affect your medical career, your family, your sanity?
 
There's nothing wrong or selfish about wanting to put your medical career first. This is your career, and it will effect your family and your life. You have to approach HPSP/USUHS with the understanding that there will be payback involved for the benefits of military commitment. Knowing as much as possible about what the benefits and drawbacks are can help with this decision.

The military match is subject to so much variability that one cannot accurately say whether it is easier or harder as compared to the civilian match. The numbers are small and the needs of the military change. Don't cloud your vision with this too much. If you truly want to serve, try to extrapolate what your career would be like if nothing went your way: meaning does the desire to serve trump the thought of a transitional year followed by a 4 year GMO in a miserable location? How will this affect your medical career, your family, your sanity?
Yes, I have been trying to look at the possibility as being a very real circumstance that I could enter. My Fiance is a BSN,RN and the people I have talked to have said that she would be very employable in most duty stations or at nearby hospitals? Do you think thats the case?

I would just love the opportunity to serve our guys over seas. Though in the position as an specialist not a GMO and thats the catch that I am hung up on.
 
Most of the quotes that I've heard for small towns 1-1.5 hrs from a major city or smaller cities are around 220-240 K in the first 1-3 years. As you improve your efficiency, a lot of people push it to 280-320K/yr. The bottom is that your salary is closely tied to the number of pts/day *10. For example, let's say that you're seeing about 4 pts/hr for a day work of about 32 pts. You can expect your income to be around 300-340K/yr.

Remember that the salaries also come from clinicians who makes about 20-30% from the average of the clinicians. Like I said, a total loan of 200-250K out of med school is very doable. Finally, if you are going into primary care, there are thousands of programs out there that will forgive your debt.

Yea, I have looked at those programs. I just have a grandiose sense of being able to my part. Then again there are countless others that have been dissapointed going in with my same mindset. Thanks for the break down on the numbers those do help my understanding. My desires to go into medicine are not money and dont want to come off like it is lol. Just want to be comfortable and be able to support a family after I am done with my training.
 
Under any circumstances do you recommend HPSP/milmed?

Sure. Do you desire to serve in the military? Does the desire to serve outweigh any delays or hiccups in your career progression. I had money and took the scholarship anyway because I wanted to serve in the .mil, though I never planned a .mil career.
If you want to serve, the stool sandwiches that they serve so often don't taste so bad. I lost a ton of money by going HPSP. More than your debt estimate. No regrets.


--
Il Destriero
 
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Sure. Do you desire to serve in the military? Does the desire to serve outweigh any delays or hiccups in your career progression. I had money and took the scholarship anyway because I wanted to serve in the .mil, though I never planned a .mil career.
If you want to serve, the stool sandwiches that they serve so often don't taste so bad. I lost a ton of money by going HPSP. More than your debt estimate. No regrets.


--
Il Destriero
This is the hard part. Very well put and a lot of food for thought. For me at this point it's not for the money but more for the experience but it's hard to know if it would be worth it.
 
Hello All,

This is my first time posting. Just wanted some input as I have lurked and read most of the posts on this page and have also tried to talk to as many current physicians in the military as possible. So a little back story I was admitted into an osteopathic school last year but ended up deferring a year for some personal reasons during that time I retook the MCAT, and published twice and figured I would apply next cycle as well in hopes to be admitted to schools closer. I was fully committed to military medicine as I looked at the pros and cons and looked at the military as a place I could have a chance to match into specialties that would be really hard in the civilian side and the uncertainty of how the (AOA ACGME) merger was going to affect osteopathic physicians looking into competitive specialties. So fast forward a year I have been accepted into UCLA DGSOM and don't know what I should do about taking HPSP (AF by the way). I wanted to serve before I went to college but didn't because of the career I wanted I figured it would put me really far behind.

Financially I will most likely graduate at the normal in debt range 200-250k if I took out the loans which right now is definitely terrifying. I just am having trouble deciding which way is better financially and career wise. As you can scour the forum reading about how these superstars are considering a research year with there 245 step score in order to make sure they match.

Really would love some constructive input.

1). What, exactly, will your debt be? You have an acceptance to a specific school, it shouldn't be a range.

2). Is 200-250 K the principle or the amount you will owe when you finish residency?
 
1). What, exactly, will your debt be? You have an acceptance to a specific school, it shouldn't be a range.

2). Is 200-250 K the principle or the amount you will owe when you finish residency?


1. Depends on my fiancé as she will be helping pay for rent etc but she is waiting on one job right now in hopes to get into a better job closer to LA so I am expecting right now to have to take out more for the first year.
2. With our two incomes I would hopefully be able to make payments during residency so it doesn't capitalizing post school. Realistically I would expect 230-250 to be most likely as nothing goes as smoothly as possible.
 
1). What, exactly, will your debt be? You have an acceptance to a specific school, it shouldn't be a range.

2). Is 200-250 K the principle or the amount you will owe when you finish residency?
So yes principle pre residency is going to be 200-250
 
Not to take away from OP, but my # will be between 80-100 after residency. I would lose money in the long run, unless I do primary care?
 
Not to take away from OP, but my # will be between 80-100 after residency. I would lose money in the long run, unless I do primary care?
You would loose money in all situations from what I've researched. You can search what pay would be which is 100-120k after residency in military. Civilian you can look at above comments and see the numbers. You would be doing it for the thought of service not pay in my opinion but maybe one of more seasoned guys can help you out.
 
I just got accepted for the AF HPSP. My loans are 83k for each term so I'm looking at possibly 334k debt. Do you think it is worth it to go through with HPSP? No prior experience. I was thinking of doing orthopedics or anesthesiology but who knows how well I will do in med school.
 
I just got accepted for the AF HPSP. My loans are 83k for each term so I'm looking at possibly 334k debt. Do you think it is worth it to go through with HPSP? No prior experience. I was thinking of doing orthopedics or anesthesiology but who knows how well I will do in med school.

Yes. At that level, "doing it for the money" starts to make a lot more sense. Even if you land a very high paying specialist job, 1. You won't lose a lot and 2. You're making a ton of money, so it won't matter.
Though I still think you need to have a desire to serve in the military or you'll probably focus only on the negative and be miserable.


--
Il Destriero
 
Yes. At that level, "doing it for the money" starts to make a lot more sense. Even if you land a very high paying specialist job, 1. You won't lose a lot and 2. You're making a ton of money, so it won't matter.
Though I still think you need to have a desire to serve in the military or you'll probably focus only on the negative and be miserable.


--
Il Destriero
I talked to a cardio thoracic guy in San Antonio yesterday. He mentioned tat his workload is pretty solid considering its a level 1 center this seems counterintuitive to what I have read on the forum here? Any thoughts?
 
What does he mean by workload? Does that include non-clinical? Does it include general surgery cases? Does it include complex CT cases, or just bread-and-butter? Is he getting those cases at SAMC, or by doing ODE in town - which is a privilege that can be revoked at any time and for any reason?
How does it actually compare to the average civilian practice? I know plenty of guys who think they're "pretty busy" in the Army who really aren't even justifying their paycheck.
And in the end, remember that only so many guys get to do CT at SAMC. The situation could be entirely different elsewhere.
 
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What does he mean by workload? Does that include non-clinical? Does it include general surgery cases? Does it include complex CT cases, or just bread-and-butter? Is he getting those cases at SAMC, or by doing ODE in town - which is a privilege that can be revoked at any time and for any reason?
How does it actually compare to the average civilian practice? I know plenty of guys who think they're "pretty busy" in the Army who really aren't even justifying their paycheck.
And in the end, remember that only so many guys get to do CT at SAMC. The situation could be entirely different elsewhere.


He does all his work out of SAMC not sure if he moonlights or anything else. He did say his work load will go up after he finishes his commitment but in his words he did not feel like he will be unable to keep up in the civilian sector. My interests are right now atleast not in CT. I really want to do ortho but that may change, but he said ortho spots will always be needed in the MIL.
 
He does all his work out of SAMC not sure if he moonlights or anything else. He did say his work load will go up after he finishes his commitment but in his words he did not feel like he will be unable to keep up in the civilian sector. My interests are right now atleast not in CT. I really want to do ortho but that may change, but he said ortho spots will always be needed in the MIL.

Did he seem happy with his choice to do HPSP?
 
Did he seem happy with his choice to do HPSP?
Yea, he seemed pretty happy with his decision. He was one of those that got to do a civ deferred program got his fellowship so he had nothing to complain about except the pay lol.
 
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Yes. At that level, "doing it for the money" starts to make a lot more sense. Even if you land a very high paying specialist job, 1. You won't lose a lot and 2. You're making a ton of money, so it won't matter.
Though I still think you need to have a desire to serve in the military or you'll probably focus only on the negative and be miserable.


--
Il Destriero
And I have 33k loans from undergrad that I am still paying lol. I am really the type that can adapt to any environment and situation. I just make the best of my situation regardless, so serving the military I see as a good addition to my experiences while helping me with my debt. Also I am not good with money so it will be better for me to be coming out debt free than to have to plan how I will pay off my debt while resisting the urge to spend lol
 
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Yea, he seemed pretty happy with his decision. He was one of those that got to do a civ deferred program got his fellowship so he had nothing to complain about except the pay lol.

Has he deployed yet?
 
I am really the type that can adapt to any environment and situation. I just make the best of my situation regardless, so serving the military I see as a good addition to my experiences while helping me with my debt. Also I am not good with money so it will be better for me to be coming out debt free than to have to plan how I will pay off my debt while resisting the urge to spend lol

you're my twin...

will the mil forgive your undergrad loan too or are you going to just pay that with the $ that you get?
 
you're my twin...

will the mil forgive your undergrad loan too or are you going to just pay that with the $ that you get?
No, from my understanding just graduate stuff. Undergrad you have to pay off on your own even with FAP.

I don't know about deployment, I forgot to ask but I am going to email him later so I will ask.
 
I am really the type that can adapt to any environment and situation. I just make the best of my situation regardless. So I feel that whatever things that come to me as a surprise while in the military I can bounce back from/adapt if you know what I mean.
you're my twin...

will the mil forgive your undergrad loan too or are you going to just pay that with the $ that you get?
I am going to pay some of it off with the money I receive. That was my plan.
 
I just got accepted for the AF HPSP. My loans are 83k for each term so I'm looking at possibly 334k debt. Do you think it is worth it to go through with HPSP? No prior experience. I was thinking of doing orthopedics or anesthesiology but who knows how well I will do in med school.
Take a look at a good discussion that happened here a few years ago: The skyrocketing value of the HPSP scholarship Food for thought.

Not doing it for the money still holds true, but I estimate that I got about a 500K benefit from taking the HPSP. Of course, I would pay all that back plus interest right now if I could get the last 3 years back, but that's a moot point.
 
Take a look at a good discussion that happened here a few years ago: The skyrocketing value of the HPSP scholarship Food for thought.

Not doing it for the money still holds true, but I estimate that I got about a 500K benefit from taking the HPSP. Of course, I would pay all that back plus interest right now if I could get the last 3 years back, but that's a moot point.


I have noticed that you really dont recommend HPSP. Why has your experience been so bad? Is it super common for HPSPers to have a bad experience or what?
 
Take a look at a good discussion that happened here a few years ago: The skyrocketing value of the HPSP scholarship Food for thought.

Not doing it for the money still holds true, but I estimate that I got about a 500K benefit from taking the HPSP. Of course, I would pay all that back plus interest right now if I could get the last 3 years back, but that's a moot point.
But I'm looking at it as in I will be unsure how i will do in medical school and unsure how competitive I may be. I do not know what the future will hold so to come out with no debt but a military commitment of 4 years mininum isn't too bad for me.
 
Not to take away from OP, but my # will be between 80-100 after residency. I would lose money in the long run, unless I do primary care?
So debt compounds during medical school and residency residency, and unless you do an EM residency you probably won't have the option to moonlight enough to pay any significant amount of it off. It will also compound during your repayment plan itself. Student debt is also paid with post tax dollars.

A simple rule of thumb is that you will need to earn 3 times what you borrow, pre tax, to pay your debt back.

The military also pays about 100K more during residency and medical school than the civilian world.

So take you debt, multiply by 3, add 100K, and divide by 4. If the difference between your civilian and military pay is less than that number, you will be coming out financially ahead with HPSP
 
But I'm looking at it as in I will be unsure how i will do in medical school and unsure how competitive I may be. I do not know what the future will hold so to come out with no debt but a military commitment of 4 years mininum isn't too bad for me.


Dude these are terrible reasons to join. If your not a good student then you will spend your time as a GMO and if you aren't a residency trained physician and will just have a fancy piece of paper.
 
Dude these are terrible reasons to join. If your not a good student then you will spend your time as a GMO and if you aren't a residency trained physician and will just have a fancy piece of paper.
I'm being modest bro. I dont mean I'm going to flunk out of med school. I meant I might be competitive for primary care rather than something as cometitive as ortho. You know what I mean? So the potential benefits of the HPSP program are dependent on an unforseeable future (I will just assume Im competitive for primary care vs other more competitive specialties).
 
I have noticed that you really dont recommend HPSP. Why has your experience been so bad? Is it super common for HPSPers to have a bad experience or what?
No, I don't recommend HPSP. My experience has been bad because I have not been able to return to training, which has been my #1 goal. I don't think it's common for people to have a very bad experience with HPSP, I think the majority are probably okay with it.

If you've been reading my posts then you know how I feel: In my opinion, a pre-med is not in a position to sign away control of their medical career before they even begin anatomy lab. A lot of things can change in a person's life between orientation and graduation, and very often the people who enter med school wanting to do FM in a rural setting change their minds to trauma surgery, and vice versa. In the military, you are subject to several disadvantages in obtaining medical training that civilians are not; namely limited geography, vacillating slots due the nebulous "needs of the Army", and the tyranny of small numbers.

If you want to serve, serve. But remember that servants don't get to choose how or where they serve. They can make requests, but it's up to the master. You are sacrificing a lot of autonomy by joining, so you need to have eyes open before signing up.
 
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But I'm looking at it as in I will be unsure how i will do in medical school and unsure how competitive I may be. I do not know what the future will hold so to come out with no debt but a military commitment of 4 years mininum isn't too bad for me.
I really don't understand what that means but if it makes sense to you, go for it. If you are unsure about the future, then you will be happy to know that one of the best facets of HPSP is that you are guaranteed an internship somewhere. It might be a TY but you will be in a position to finish internship and get licensed. Although, GME is always on the cutting board and there's talk of getting rid of every training program that doesn't directly contribute to readiness, so who knows what that even means or if it happens. But you've got that internship going for you. Which is nice.

upload_2017-5-31_22-40-6.png
 
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Dude these are terrible reasons to join. If your not a good student then you will spend your time as a GMO and if you aren't a residency trained physician and will just have a fancy piece of paper.
Pardon me, but people who are good students also serve GMO time for various reasons, to include switching specialties, being unsure as to what they want to specialize in, or smart people who just had bad luck.

Also, you need an internship to get licensed, which you will absolutely get in the military. You won't head up a department at MGH but you will be able to work and make a living.
 
Pardon me, but people who are good students also serve GMO time for various reasons, to include switching specialties, being unsure as to what they want to specialize in, or smart people who just had bad luck.

Also, you need an internship to get licensed, which you will absolutely get in the military. You won't head up a department at MGH but you will be able to work and make a living.


What I was aiming for is that using the military for a safety net is something most on here would highly discourage? Sure if you want to serve then it can be a advantageous experience. There are programs out there for generalists that will help them pay back loans? IDK wasn't meaning to come off as a know it all as obviously I don't.


So you think counting on GME in the military is a risk? What about the civilian world where 92% of medical school match compared to the 88% in the Air Force? Being in that 8% with 250k in loans is pretty terrifying in my opinion. There will always be a need for ED,Ortho, FM and GS in the mil right? I am sorry about your training as of now are you just waiting to match after you serve your AD?
 
What I was aiming for is that using the military for a safety net is something most on here would highly discourage? Sure if you want to serve then it can be a advantageous experience. There are programs out there for generalists that will help them pay back loans? IDK wasn't meaning to come off as a know it all as obviously I don't.


So you think counting on GME in the military is a risk? What about the civilian world where 92% of medical school match compared to the 88% in the Air Force? Being in that 8% with 250k in loans is pretty terrifying in my opinion. There will always be a need for ED,Ortho, FM and GS in the mil right? I am sorry about your training as of now are you just waiting to match after you serve your AD?
Well you make the point about 92% of med school grads (and is that number really that high? Is that 92% of US allopathic grads, not accounting for foreign and international grads?) don't match, meaning no internship. The military guarantees you an internship. In that sense it is a safety. Yes the mil will always need the above mentioned specialties, but when it comes your time to apply those 30 spots might be whittled down to 24 because of GMO slots, LTC's who feel like picking up another specialty, and juiced in scions. That's a 20% drop in available slots, this is the tyranny of small numbers we talk about. The military is a sure thing for internship but not so much for full residency training. Most do train in their chosen (or compromised) fields. That is the average outcome. But when you get bounced to GMO land, it's 100% happening to you.
 
@WernickeDO In your GMO position do you feel that you're able to keep growing your skills? Or are you tasked with a lot of admin bs?
 
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