Is my navy HPSP plan feasible?

[DocJuan]

Please bear with me, I know a part of this question has probably been asked an infinite number of times on this forum. I'm wondering about the worth to the HPSP scholarship to my specific circumstance. Currently already 100K in debt from college and grad school loans and I won't even start medical school until August.

After medical school, I intend to go for an MHA and leverage my MD to go into hospital administration (expensive way to do this I know, but effective). Military experience could help in this regard as well (my mom is hospital CEO and said half her MHA class was military) My plan was to take the 4 year scholarship and (hopefully) match into Emergency Medicine. Since payback time starts after internship year I figure I'd only have 2 years of residency and 2 years as an attending before I can get out. After leaving I'd try to moonlight and work part-time in the civilian world while pursuing an MHA.

Is this a feasible plan? Am I overlooking any potential major roadblocks? Any help is appreciated! Thank you.

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[SeminoleFan3]

Um, not if you want all of med school paid for. If you take 4 years of HPSP, then you owe 4 years, which starts (for all intents and pursposes) after residency. EM is difficult to match into (in the Navy) and you usually do a GMO tour first.

 

[DocJuan]

Um, not if you want all of med school paid for. If you take 4 years of HPSP, then you owe 4 years, which starts (for all intents and pursposes) after residency. EM is difficult to match into (in the Navy) and you usually do a GMO tour first.

Thanks for response. I was assured my by recruiter that payback time starts after internship year (second year of residency), is it possible that this is a newer policy?

I absolutely do not want to waste time doing a GMO tour first, do they get preference over interns? My recruiter said only people who can't get a residency do GMO. I'm not too worried about competitiveness as long as they're offering the residency. I tend to do very well on standardized tests so I'm making the assumption my Step 1 will be more than competitive.

 

[SirGecko]

It isn't a new policy. Either your recruiter doesn't understand the way the payback works or didn't accurately explain it to you. (it seems like something that is fairly commonly miscommunicated to people)

Basic summary of how payback works that I posted on a recent thread, copied here: "This is a question that has been answered a lot on the forum but people do find it confusing and there is some misinformation that recruiters sometimes spread. If you have a four year scholarship it is a four year commitment. Time in training does not count toward paying off this commitment. So say you graduate medical school and do an internal medicine internship followed by going strait through to residency. You would then have four years post residency to pay off before your are done with your commitment. Where it gets more complicated is if you have a longer residency or you have to do a GMO tour in between intern year and residency. Time as a GMO counts toward payback but when you go back to residency you also accrue additional obligated service. This obligated service is served concurrently with obligated service from medical school. (or other education programs) So say you do one year of internal medicine internship then go out for a two year GMO tour before returning to finish your residency. In this scenario you paid off two years as a GMO and then you come back to residency and accrue two more years of payback. You now have two years owed from residency and two from medical school. You pay both of these off at the same time so you have two more years total of obligated service. If your residency was longer, say a four year residency like radiology, you would have two years left on your medical school payback and four years from your residency payback. So it that scenario you would owe four additional years post residency. Hope that helps."

Of note you should understand that if you do navy HPSP it can be very difficult to match ER (its pretty popular, lots of applicants) and there is a good chance you will need to do a GMO tour. Again your recruiter is wrong, GMO's in the Navy at least are not just "people who can't get residency" and even assuming that you will do well in medical school that is not necessarily a protection against needing to do a GMO tour. Plenty of very competitive applicants have to do GMO tours. Finally I would caution you against assuming your step scores will be good based on your ability to take standardized tests. You know who else does well on standardized tests? Nearly everyone in medical school. Try to be the best, work hard to be the best but it is a fools game to bet on it before you even start medical school.

 

[Onefellswoop87]

Thanks for response. I was assured my by recruiter that payback time starts after internship year (second year of residency), is it possible that this is a newer policy?

I absolutely do not want to waste time doing a GMO tour first, do they get preference over interns? My recruiter said only people who can't get a residency do GMO. I'm not too worried about competitiveness as long as they're offering the residency. I tend to do very well on standardized tests so I'm making the assumption my Step 1 will be more than competitive.

Your recruiter is being a recruiter. Either intentionally or naively giving half-truths.

1. Payback from is served only when you are practicing independently (as a GMO or an attending). Residency doesn't count for payback. A long residency (longer than your current payback) increases your payback time.

2. EM is as competitive or more in the DoD than as a civilian. Traditionally, at least in the navy, the entire EM residency class was 100% prior GMOs. There is a new (a few years old now) Navy EM internship that yields some straight through interns to residents but that isn't a guarantee.

 

[DocJuan]

It isn't a new policy. Either your recruiter doesn't understand the way the payback works or didn't accurately explain it to you. (it seems like something that is fairly commonly miscommunicated to people)

Basic summary of how payback works that I posted on a recent thread, copied here: "This is a question that has been answered a lot on the forum but people do find it confusing and there is some misinformation that recruiters sometimes spread. If you have a four year scholarship it is a four year commitment. Time in training does not count toward paying off this commitment. So say you graduate medical school and do an internal medicine internship followed by going strait through to residency. You would then have four years post residency to pay off before your are done with your commitment. Where it gets more complicated is if you have a longer residency or you have to do a GMO tour in between intern year and residency. Time as a GMO counts toward payback but when you go back to residency you also accrue additional obligated service. This obligated service is served concurrently with obligated service from medical school. (or other education programs) So say you do one year of internal medicine internship then go out for a two year GMO tour before returning to finish your residency. In this scenario you paid off two years as a GMO and then you come back to residency and accrue two more years of payback. You now have two years owed from residency and two from medical school. You pay both of these off at the same time so you have two more years total of obligated service. If your residency was longer, say a four year residency like radiology, you would have two years left on your medical school payback and four years from your residency payback. So it that scenario you would owe four additional years post residency. Hope that helps."

Of note you should understand that if you do navy HPSP it can be very difficult to match ER (its pretty popular, lots of applicants) and there is a good chance you will need to do a GMO tour. Again your recruiter is wrong, GMO's in the Navy at least are not just "people who can't get residency" and even assuming that you will do well in medical school that is not necessarily a protection against needing to do a GMO tour. Plenty of very competitive applicants have to do GMO tours. Finally I would caution you against assuming your step scores will be good based on your ability to take standardized tests. You know who else does well on standardized tests? Nearly everyone in medical school. Try to be the best, work hard to be the best but it is a fools game to bet on it before you even start medical school.

Thanks so much for the information. This really clarifies things and what you just described would be a very rude awakening. Under this circumstance it seems like it would always be a better idea do civilian residency and pay back your time as an attending?

You're definitely right about the Step, I just wanted to base the question on assumption that I'm competitive for EM. I have no idea how I'll do!

 

[Onefellswoop87]

Thanks so much for the information. This really clarifies things and what you just described would be a very rude awakening. Under this circumstance it seems like it would always be a better idea do civilian residency and pay back your time as an attending?

You're definitely right about the Step, I just wanted to base the question on assumption that I'm competitive for EM. I have no idea how I'll do!

You don't get the choice to tell the DoD I'll do the civilian residency and do my payback as an attending. They pay for school, you participate in the military match process. They might defer you (for a 1 year internship or for the whole residency) but you should go into the HPSP with informed consent and assuming you'll participate in the military match (because most students do).

 

[j4pac]

If GMO isn't apart of your plan...Navy HPSP would be a horrible mistake.

 

[Red Lobster Actual]

Been talking to some EM residents recently. Navy EM residency is gradually closing their doors to returning GMOs. Within the next few application cycles they will be taking a few to one and then no GMOs.

 

[backrow]

Been talking to some EM residents recently. Navy EM residency is gradually closing their doors to returning GMOs. Within the next few application cycles they will be taking a few to one and then no GMOs.

It's not that they are necessarily closing to returning GMO's , but rather a few different issues are coming to a head.

1) The EM RRC has a new rule that anybody who is out of GME for 3 years must repeat EM internship. If you go flight or dive (or do longer than 2 with the others) and for whatever reason you can't arrive on July 1 (deployed, CO won't release you...whatever) you would all the sudden have to repeat intern year. My understanding is the Navy has asked for relief from this rule without success to date.

2)Since EM has their own internship now it is becoming harder for non-EM interns to return after GMO to EM. There will eventually become an equilibrium between number of EM interns in GMO billets and number of openings in programs. When that happens the reality for non-EM interns to go to EM residency is going to probably require EM interns to do GMO tour and get out of the Navy. The other possibility is to get a deferment which will probably be a reasonable expectation over the next handful of years as the "Blue in Support of Green" billets get ramped up.

3) EM seems to be taking more straight through; however, they will still likely have a few go out to GMO's each year to essentially "make room" for those who have previously gone out to the fleet. If they ever go full "straight through" they might have to do something like ENT right now where they greatly reduce or take no interns for a few years.

What I think those who don't get selected for EM internship and want to do EM should think about doing is this: do a great job as a TY and work with the EM folks to get good future letters. Do your GMO time and then apply for a deferment or get out. Do residency at one of the 3 year EM residency programs. This plan means you don't add an extra year of GME that isn't necessary. If you come back to Navy EM you'll have to repeat some or all of internship and then still do 3 years of residency. If you go to a 3 year EM program you'll only do 3 years even if you have to repeat all of internship.


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