Army HPSP recruiting, retention?

[Mt Kilimanjaro]

Anybody have any updates on Army HPSP recruiting recently?

Many people are saying that it has not filled the past few years which, combined with abysmal retention across most specialties, seems like the beginning of the end for the MHS/DHA Frankensystem. God knows they won’t find sufficient numbers of competent, otherwise employable civilians to toil in these conditions.

Glad I’m just a few months away from a suit and tie. Sad for those left behind.

If you’re considering HPSP: Don’t.

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[DrMetal]

Anybody have any updates on Army HPSP recruiting recently?

Many people are saying that it has not filled the past few years which, combined with abysmal retention across most specialties, seems like the beginning of the end for the MHS/DHA Frankensystem. God knows they won’t find sufficient numbers of competent, otherwise employable civilians to toil in these conditions.

Glad I’m just a few months away from a suit and tie. Sad for those left behind.

If you’re considering HPSP: Don’t.

I don't know about the Army, but we seem to have a good steady stream of applicants for the Navy HPSP (I'm interviewing 4-5 applicants a month).

Most seem to be going to expensive private schools. I counsel them extensively about the perils of doing it just for the money, the possibly of breaks in training (GMO), etc. None seem to mind it that much, they still want to do it.

 

[armytrainingsir]

It’s hard for a 22 yo kid to not take a bite out of a 300k carrot, even when it has a warning on the label.

HPSP isn’t going anywhere due to lack of applicants anytime soon, especially with the rise of the outrageously expensive for-profit DO schools popping up everywhere these days.

 

[DOswag]

Anybody have any updates on Army HPSP recruiting recently?

Many people are saying that it has not filled the past few years which, combined with abysmal retention across most specialties, seems like the beginning of the end for the MHS/DHA Frankensystem. God knows they won’t find sufficient numbers of competent, otherwise employable civilians to toil in these conditions.

Glad I’m just a few months away from a suit and tie. Sad for those left behind.

If you’re considering HPSP: Don’t.

Yeah I think Air Force has still has a good number of applicants if I'm not mistaken, but retention is low. Probably not going away anytime soon. But congrats on making it through pay back. I'm right there with you. Separating from Air Force this summer to go civ side. End of July can't come here fast enough.

 

[backrow]

Most seem to be going to expensive private schools.

Allow me to rephrase:

Most seem to be going to brand new DO schools, have little to no direct hospital affiliation, cost a ton of money, and rely on HPSP as a way to sell being able to afford their school. Oh, and frequently tout their military friendly curriculum, or their military “program” of some sort.

 

[DrMetal]

Allow me to rephrase:

Most seem to be going to brand new DO schools, have little to no direct hospital affiliation, cost a ton of money, and rely on HPSP as a way to sell being able to afford their school. Oh, and frequently tout their military friendly curriculum, or their military “program” of some sort.

Yeah, pretty much. With this influx of students (just in general, military or civilian), one wonders what all of them will do for post-graduate training (given that the # of residency spots isn't increasing much). An expensive/flashy DO without a residency is like a Gibson Les Paul without an amp.

 

[DOswag]

Yeah, pretty much. With this influx of students (just in general, military or civilian), one wonders what all of them will do for post-graduate training (given that the # of residency spots isn't increasing much). An expensive/flashy DO without a residency is like a Gibson Les Paul without an amp.

Probably civ deferred intern training and then GMO/FS billets getting filled giving the mil their cheap lesser trained docs to fill spots.

 

[Correlate Clinically]

The AF still fills. I haven't been interviewing applicants, but I've been told the applicant pool has changed over the last few years. What other's have said above doesn't really surprise me. We still do get good, highly qualified people, but my impression is less so than in the past. Some of that is cyclical or due to the business cycle/economy.

Retention has never been good. There's cliff at 4 years out of residency, another one at 7, and then a smaller (probably more salty and bitter one) at 11-12 years. It's been that way for a long time.

 

[pgg]

The AF still fills. I haven't been interviewing applicants, but I've been told the applicant pool has changed over the last few years. What other's have said above doesn't really surprise me. We still do get good, highly qualified people, but my impression is less so than in the past. Some of that is cyclical or due to the business cycle/economy.

While I'm sure there are some cyclic characteristics, the macro trend is concerning. It's been concerning for a long time.

30 years ago, HPSP had significant numbers of people from Ivys and other top tier schools. That isn't the case any more. Now it's absolutely dominated by newer, very expensive DO schools. When was the last time you ran into a HPSP'er from Harvard?

Posters on this forum, wherever they fall on the pro/con spectrum, are universally in agreement that it is unwise to take HPSP for just for the money. But obviously, if you look at the trend of matriculants in the last three decades, taking it for the money is what is actually happening. If the military GME opportunities, circumstances of attending practice, or relative pay were on par with the 1990s we'd still have top schools well represented in HPSP. But they're not - the people who've been signing up for HPSP the last 15-20 years are mostly those who need to cover the outlandishly escalating tuition of a certain group of schools.

For this reason alone, HPSP is going to continue to fill. We saw in the ~2006 time frame, when Iraq was getting 'Nam-ish, when the program didn't fill, that the services immediately threw a bunch more money at the program (signing bonuses, increased stipends) and the program filled again. It's the money.

We can bark up the "don't do it for the money" tree all we want, but that's why people join.


As for still getting good, highly qualified people ... that trend has also been downward over the last couple decades. You can probably reasonably argue that the people we've been getting have been good enough. Anyone who gets into any medical school, anywhere, is definitely on the right tail of the overall bell curve of society. But we can't reasonably argue that the people we've been getting have been among the best. I probably don't need to rehash or compare the gpa/MCAT profiles of average matriculants at different schools. We all know that the expensive osteopathic schools without affiliated teaching hospitals are getting the students who couldn't get into state/public universities or the old allopathic privates, and we know where the fertile HPSP recruiting grounds are.

 

[Correlate Clinically]

Good points, and I won't argue that the trend is negative. I've heard it from too many other department heads and program directors over the last few years.

There is also a lag, depending on length of residency. What I see (at non-GME sites) is based on selections 5 years ago, but even that does hold true to trendline.

If there is a major recession, it might bump competition and through that increase applicant quality. But even that would probably be a blip until it's no longer as economically attractive.

For all my gripes with military medicine, it was historically fair to say that most military MD's were actually pretty good. There's a group that embrace admin and climb the ladder at the expense of clinical competence, but it's not a big group. It's been my experience that the average military physician in my specialty is better than the average civilian. I know I'm biased and the sample pool is smaller. In terms of averages (there are extremes everywhere; amazing and terrible MD's can be found where ever you look hard enough), the military had generally good people to work with.

It's actually probably been a factor in supporting the sagging and failing military health system. Motivated, capable people working in a broken system to prevent harm until they burn out or separate. The long term consequences of not having that base material to work with is probably not going to be good.

 

[Carcassonne]

Agree with the above regarding applicant quality at least for residency. In 5 years, it seems the applicant pool (and moreover who gets matched)... is different. Our program used to brag about getting their top ranked applicants, but now it's more scattered. The end quality resident may be the same, though, since CVs don't tell everything.

Regarding retention, there was no effort made to retain me (maybe they knew me too well), even though we now have 0 subspecialists at my base when at times we had 4. Some of these patients the other surgeons are happy to take, others they will punt that consult on 1st and goal to the civilian sector. Rumor was that at another base they were offering $500,000 a year for a contractor to cover that speciality...

The biggest irony was that during terminal leave, I received an e-mail from another military branch offering a $600,000 signing bonus for joining. So, no, they don't retain.