NHSC giving worst locations to scholars, saving good ones for loan repayment?

[billyrickybobby]

Details are sketchy at this point, but it seems that NHSC scholars getting placed in 2010 are being given far fewer service locations this year than years past. It's something to consider before signing an NHSC scholarship contract.

An HPSC announcement on June 23rd in the Federal Register says that the need level of clinics (HPSA score) that can employ scholars is going up to 17 (from the score of 14 where it had been for years). I can't find an explanation for the change, but this greatly reduces the sites available for scholars. The reality is that the remaining sites are even more remote and/or harsher communities for scholars & their families. Added to that, there will be greater competition over the remaining sites which means this year more scholars will be put in locations they didn't choose. If you can't find a service site that is livable for you they will assign you whatever site they choose.

It's probably not a coincidence that at the same time, with new ARRA stimulus money from the government the NHSC is greatly expanding the service sites available to their loan repayment program, lowering the minimum HPSA score to 10 (down from 14).I haven't found a history of the scores, but I believe (?) in the past the scores for scholars & loan repayment were generally the same. The May 28 Federal Register announcement about loan repayment essentially says they will preferably fill the sites with scores >= 10 but will lower the minimum score as needed. AAIM says on their website that the NHSC has said the minimum score might go as low as 8 for loan repayment.

I can't shake the feeling they're being a bit sneaky about this change for scholars because they announced it June 23 immediately after the 2009 NHSC Ambassadors conference June 18-20. (They had a gathering of clinic/health ambassadors & didn't bother to mention the change announced 3 days later?).

NHSC has recently (finally, a month later) updated part their website to reflect the change, but only on the top of the "Sites/Communities" page... on the "Scholarship" page they are STILL saying "this year, a HPSA score of 14 or higher, depending on discipline and specialty"

Optimistically, maybe they're still getting their act together and they will improve the choices for 2010 scholar service once they get things sorted out. If the program really hopes to encourage doctors to permanently settle in the communities of their NHSC service, I hope they come up with something better.

Pessimistically, I'm afraid that because scholars are already obligated to serve the NHSC is forcing them to take the worst locations so that they can entice these new ARRA loan repayment to sign up with more liveable locations. If so, you should consider that as a scholar you are a lower priority and at a large disadvantage, subject to whatever the rules might be on your placement year-- based on a contract you could have signed 7 years earlier. And, as you must be aware, the only way out is to pay the incredible penalty of THREE TIMES what they paid out for you.

The Aug 13-15 Scholar Orientation in Tampa should be, ahem, spirited!

Anyone with more info on these changes & the reasoning?

---

Members don't see this ad.

 

[keithslc]

I saw this on their site also. Must be the first thing in 10 years that has been updated on their website. I wasn't too happy about them arbitrarily raising the score. I also noticed they now say that the pay they offer has to be equivolent to a similiar civil service job for the area. They used to say that sites had to pay wages competetive for the area you are placed in.
There has to be some guidlines for the contract agreement. It should speak for itself that you cant force positions that are unreasonably unfit for living. Underserved doesn't equate to unlivable.
I have yet to speak with someone that isn't rude and unhelpful, it must be a requirement for employment with the scholarship program.
Signing up for this gig was not a smart choice on my behalf.

 

[smq123]

I wasn't too happy about them arbitrarily raising the score. I also noticed they now say that the pay they offer has to be equivolent to a similiar civil service job for the area. They used to say that sites had to pay wages competetive for the area you are placed in.

Well, according to them, it wasn't arbitrary.

Given the lower number of scholars available for placement in this cycle, the NHSC has determined that a minimum HPSA score of 17 will enable it to meet its statutory obligation to identify approved service sites at least equal to, but not greater than twice, the number of NHSC scholars available to serve.

So it makes me wonder if, in future years, they'll lower the minimum HPSA score back down to 14 or something. Still, I agree - this sucks.

 

[billyrickybobby]

If you're currently considering an NHSC scholarship I'd strongly suggest that you have a close look at what's happening with placements in the 2009-2010 cycle and ask questions of your NHSC contact before you sign. Discuss possible scenarios in your future & how NHSC scholarship policy will or won't accomodate them.

This year is demonstrating how much control you are signing over to the NHSC, which can (by many accounts) be a difficult organization to navigate and communicate with. Be sure you clearly understand what you're actually giving up vs. the value of the scholarship. Certainly talk to anyone you know that just graduated from residency about the opportunites available to them entering practice. I'm not suggesting the scholarship is strictly a good deal or bad deal, just that a lot can change between the time you sign & when you are placed-- both with the NHSC scholarship & your personal life.

With government healthcare initiatives in the works, how might today's scholars be affected when they graduate residency... will the score go back down or could universal health insurance coverage create even greater need for doctors in even more extreme remote locations that scholars will be obligated to fill?

Given the lower number of scholars available for placement in this cycle, the NHSC has determined that a minimum HPSA score of 17 will enable it to meet its statutory obligation to identify approved service sites at least equal to, but not greater than twice, the number of NHSC scholars available to serve.

Yes, that's the only explanation I could find as well. Any idea how specific disciplines are handled in the statutory obligation? Is each physician, by their discipline, guaranteed >=1 but <2 available positions? I haven't been able to locate a breakdown of the number of NHSC scholars placed each year (total or by discipline). I'd be interested to see how the obligation has been met in the past & if the ratio leans toward 1 position per scholar or 2 positions per scholar, as a group and by discipline.

My recollection is that the minimum score change from 14 up to 17 removed approx 900 sites for scholars, leaving 780. If the number of sites was cut by more than 50%, are there also 50% fewer scholars for placement this year or has the ratio of available positions to scholars gone down as well?

780 sounds like a lot, but it breaks down like this:

266 positions for Physicians - Primary Care
161 positions for Dentist
160 positions for Physician - Psychiatry
193 positions for other (non md/do)

for the 266 Physicians - Primary Care, the break down is:

139 positions for Family Practice
59 positions for Internal Medicine
28 positions for Obstetrics and Gynecology
40 positions for Pediatrics

...depending on the number of other scholars in your speciality and the region you'd prefer to live in, you could have considerable competition from other scholars.

In addition, don't forget that while there are only 1 or 2 approved positions available per scholar, scholars still interview for the positions like anyone else (being a scholar does not give you preference for a position), and if a site is a desireable, livable location you'll also be competing with loan repayment corp members because they can take 17+ score positions if they'd like to, but as a scholar you can't take positions with a score <17. Worse still, in the 2010 placement cycle scholars are also competing with the surge of thousands of new ARRA loan repayment corp members who can also take their spots.

It's also worth pointing out that salaries at these sites can vary by quite a bit, I've heard of two locations in the last few years offering <$80k/yr to doctors-- with negligible health benefits. (is it rude to ask the salary potential on the phone before you travel out to visit a site?). I don't know if the NHSC takes into account salary vs. any financial obligations (student loans, etc) in determining if a site is suitable for an individual... I imagine they do not.

Underserved doesn't equate to unlivable.

Fair enough, Keith, the experience will ultimately be what the scholar makes of it. Still, it's realistic & pragmatic to take into account that underserved areas (especially those 17+) are underserved for specific and substantial reasons that will invariably affect you/your spouse/your family in terms of quality of life, income, expenses, extreme weather, isolation from family/friends, opportunites for entertainment/education/recreation/etc, personal safety & higher crime rates. If you end up in a community/culture that is a challenge for you to partiicipate in and your salary is inadequate to relieve some of these factors, you (& your family) are in for a long service commitment... and a bunch of personal growth, I guess!

As an aneqdotal example I have to say, without naming names, that there are locations which are underserved literally because at times the mosquitos are so overwhelming that most people that didn't grow up in that environment find it intolerable.

All right, well someone please correct me if I'm misunderstanding any of this-- if I'm mistaken I dont want to mislead anyone & I'll edit these posts.

Is this being discussed in other fourms? I'm surprised I haven't seen responses from scholars, sites, ambassadors, or even NHSC reps about the scholar score change and the impact it has on everyone involved.

(I should note that the jobs database on the NHSC web site was still showing score 14-16 sites as available to scholars until very recently, but looking today the data on sites that used to be available to scholars is gone so I can only go by my recollection of a few days ago that approx 900 sites were eliminated. Did anyone save the scholar job report in the last few weeks?)

 

[billyrickybobby]

So it makes me wonder if, in future years, they'll lower the minimum HPSA score back down to 14 or something. Still, I agree - this sucks.

Health care reform & universal insurance coverage efforts could potentially change the focus of the scholarship program and/or keep the minimum HPSA score elevated. Many current sites are sliding-scale clinics to serve the uninsured in those populations.

From the way the NHSC is (apparently) handling the ARRA program it's a reasonable prediction that future scholars will be pushed further into less desirable sites as the bar is raised by new programs because scholars have essentially no options given the penalties. The landscape could be very different for today's scholars by the time they graduate residency.

I'm just a caveman, but the way I read your quote from the federal register it seems that they can send scholars wherever they want either by modifying the HPSA score methodology or with a campaign to register as many fringe high-need sites as there are scholars in a given cycle. Extreme example, if prison clinics were arbitrarily given a higher HPSA score then, like it or not, that's where scholars would go that year.

Any idea why the 2009-2010 cycle has fewer scholars to place? I'm still looking for the numbers.

 

[memcgee]

I'm a PA student who applied for the scholarship this year. I will graduate in December 2010--will I fall under the 2010 placement cycle? Is there any evidence to show that the increased HPSA score for scholars is going to continue into the following cycle? This has me extremely irritated, as this change doesn't just affect me, it affects my husband as well (who probably wouldn't be able to find employment in any of the sites with scores >17). I realize I haven't been awarded the scholarship yet, but had I known of this change, I probably wouldn't have applied in the first place. I really feel horrible for the physicians who applied for and accepted the scholarship several years ago and will now be facing this problem.

 

[billyrickybobby]

I will graduate in December 2010--will I fall under the 2010 placement cycle? Is there any evidence to show that the increased HPSA score for scholars is going to continue into the following cycle?

Whichever placement cycle you'll be in, there are a few reasons I predict the scores will stay higher for at least 3+ years.

1. The Federal Register announcement of the change essentially says that the minimum HPSA score went up because there are fewer scholars this cycle & that by law the cap on sites is 2 times the number of scholars. So, looking at the HRSA FY 2009 Budget Justification the table at the end of the page shows that the number of new scholars is on a downward trend, going from 189 in 2004 down to 88 in 2009.

2. I haven't decided, but if you suspect the minimum score change to 17 was influenced in some way by the $200 million in ARRA NHSC loan repayment money and the ~3500 new corp members it will bring, then the NHSC has 18 months to get new loan repayment members signed up for loan repayment, though I read the bulk of it will happen in the first 6-12 months.

3. More to the point, on that same budget justification page it is a stated goal of the NHSC to "Increase the average HPSA score of the sites receiving NHSC clinicians." (though I don't see how that can happen with the flood of new loan repayment slots being offered to sites with scores as low as 8)

 

[RadicalTour]

Once accepted, are we allowed to decline the scholarship offer?

 

[billyrickybobby]

Once accepted, are we allowed to decline the scholarship offer?

In the HRSA support FAQ pages I found article 1700 which applies to loan repayment, not scholars(there's not a corresponding question in the scholar faq, but this might mean the same is possible for scholars who are very early in the process):

Q: Can a contract be withdrawn after it has been countersigned by the Secretary?

A: Yes, however, there is a limited timeframe during which the Secretary may accept a recipient's request for withdrawal of awarded contracts. Recipients desiring to withdraw an awarded contract, must do so no later than August 17 of the Federal fiscal year (FY) in which the award was issued. In addition, the individual will be required to submit a written request to withdraw the contract and repay all amounts paid to, or on his/her behalf.

There was another page (also for LR) saying that you can cleanly get out of the contract if you withdraw in the period after you've signed the contract but before the Secretary signs it.

 

[billyrickybobby]

From the scholarship FAQ:

NHSC Scholarship Rule Changes

Question
What if the Government changes the rules after I have accepted the National Health Service Corps Scholarship?

Answer
The Scholarship agreement between you and the Secretary of the Department of Health and Human Services remains binding.

So, does this mean

"Your contract binds you to comply with the NHSC Scholarship Rules, regardless of how they change in the future." If so, essentially they can change their end of the agreement at any time while the scholar's only option is to pay huge penalties.

or I guess it could also mean:

"Your contract stands even if future scholars get better terms in their contracts."

...or both?

 

[smq123]

From the scholarship FAQ:


So, does this mean

"Your contract binds you to comply with the NHSC Scholarship Rules, regardless of how they change in the future." If so, essentially they can change their end of the agreement at any time while the scholar's only option is to pay huge penalties.

or I guess it could also mean:

"Your contract stands even if future scholars get better terms in their contracts."

...or both?

I believe what this means is that your contract may change at any time. If future scholars get better terms in their contracts, so will you. If future scholars get crappier terms in their contracts, so will you.

Your contract basically only promises that you will comply with the CURRENT regulations at any given time. So if they lower the HPSA score to 12 in the future, then great. If they raise the HPSA score to 20 in the future, then that sucks.

 

[billyrickybobby]

Health overhaul to take nearly a decade
Even if bill is signed this fall, uninsured won't get coverage until 2013

Unless you're a md/do scholar early in medical school it seems unlikely you'll be affected by health care reform even if it passes. For better or worse, one less thing to worry about I guess.

 

[cali-ob]

this totally sucks. I will graduated in 2011 and I can see that the job market is going to be completely competitive even though as an FP doc, the world should be my fricking oyster! I looked on the site last night and in a matter of weeks the number of jobs is less than half of what it used to be.
But if I understand correctly we are not limited to the jobs that are posted on that site. You can work for immigration, IHS, or prisons as well as find your own job at a FQHC if the score is at least 17. The search is just going to have to start that much earlier now.

 

[alina_s]

I was going to say that the NHSC has always given the worst locations to scholars, but maybe that was only true for psychiatry? I was very pleased with the rule changes because a required score of 17 is a huge improvement for me. I've tracked the minimum HPSA score required for psychiatry positions and it has been as bad as 21. I suspect that it fluctuates so frequently for psychiatry because there are so few scholars in psychiatry and they are only required to offer 2x as many sites as scholars. It stinks that they can change the rules after we've signed the contract but with the number of scholarships as low as it is, I'm not surprised that the site qualifications changed for FM, IM, peds, and OB.

 

[keithslc]

The problem with the designation of shortage areas is that they lump all primary care providers together when they determine an area of need. IF they have lots of internal med docs that take low income patients and no ob coverage for an area, the score for the area will be low. The sites available for OB are already ridiculously low. They are not 2x the number of scholars. With the new money allocated for loan repayment the sites are only going to get worse.

 

[keithslc]

Here is a reality check for those considering the scholarship. This is what is available for an Ob Gyn looking this year.I know there will be way more OB-GYn scholars looking than they have site openings. So how can it be said that there has to be 2x as many openings as scholars looking. This is not true.

26 total jobs available.Several are repeat listings by same employer with locations just miles apart.So there is probably about 17 total openings listed. In only 14 states.This list has not changed in a long time either.
UDS: 12808101
CHINLE COMP HLTH CARE FACILITY
(~ 171.32 miles away)
Highway 191 And Hospital Dr., Chinle, AZ 86503
URL: Not Available
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Map this result NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2009/07/30 Approved on:
2009/07/11

Verified on:
2009/05/21 HEIDI ARNHOLM, MEDICAL RECRUITER
Hwy 191 & Hospital Dr., Chinle, AZ 86503
Phone: 970-882-1550
Fax: 928-674-7703
Email: [email protected] Type: IHS
ID: 10499904E8
Sequence: 08
Score: 18

UDS: 09039AZ
ELM COMMUNITY HEALTH CENTER
(~ 39.48 miles away)
2970 S. Elm Ave., Fresno, CA 93706-5441
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NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2009/07/11 Approved on:
2009/07/11

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2009/07/16 TIM SPEECE
1430 Truxtun Ave., Bakersville, CA 93301-5246
Phone: 661-845-3731
Fax: 661-845-6472
Email: [email protected]
Type: CHC
ID: 10699906E6
Sequence: 09
Score: 19
UDS: 09039F
CENTRAL BAKERSFIELD CHC
(~ 135.01 miles away)
301 Brundage Ln., Bakersfield, CA 93304-3248
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NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2009/07/11 Approved on:
2009/07/11

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2009/06/17 TIM SPEECE
P.O. Box 1559, Bakersfield, CA 93302-1559
Phone: 661-845-3731
Fax: 661-869-1041
Email: [email protected]
Type: CHC
ID: 10699906E6
Sequence: 25
Score: 19
UDS: 09039J
LAMONT COMMUNITY HEALTH CENTER
(~ 142.71 miles away)
8787 Hall Rd., Lamont, CA 93241-1953
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NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2009/07/11 Approved on:
2009/07/11

Verified on:
2009/05/26 TIM SPEECE
P.O. Box 1559, Bakersfield, CA 93302-1559
Phone: 661-845-3731
Fax: 661-845-6472
Email: [email protected]
Type: POP
ID: 10699906ZA
Sequence: 05
Score: 20

Site Information Category / Discipline / Specialty Projected Hire Date Dates Approved and Verified Contact Information HPSA Information
UDS: 04415K
MIRIAM WORTHY WOMENS HEALTH CENTER
(~ 85.43 miles away)
401 S. Madison St., Albany, GA 31701-6601
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NHSC Scholar
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Obstetrics and Gynecology 2009/07/11 Approved on:
2009/07/11

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2009/07/20 SHELLEY SPIRES
204 N. Westover Blvd., Albany, GA 31707-2983
Phone: 229-888-6559 x209
Fax: 229-436-4107
Email: [email protected]
Type: AREA
ID: 1139991323
Sequence: 04
Score: 17

UDS: 091880
BAY CLINIC
(~ 23.42 miles away)
224 Haili St. Bldg. B, Hilo, HI 96720-2926
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NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2009/07/11 Approved on:
2009/07/11

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2009/07/06 SHARON NELSON
1178 Kinoole St., Hilo, HI 96720-4133
Phone: 808-934-3242
Fax: 808-961-5167
Email: [email protected]
Type: CHC
ID: 1159991518
Sequence: 05
Score: 17
UDS: 09188D
KEAAU FAMILY HEALTH CENTER
(~ 25.65 miles away)
16-192 Pili Mua St., Keaau, HI 96749-8134
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NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2009/07/30 Approved on:
2009/07/11

Verified on:
2009/07/06 SHARON NELSON
1178 Kinoole St., Hilo, HI 96720-4133
Phone: 808-934-3244
Fax: 808-961-4795
Email: [email protected]
Type: CHC
ID: 1159991518
Sequence: 04
Score: 17
UDS: 09188A
PAHOA FAMILY HEALTH CENTER
(~ 32.83 miles away)
15-2866 Pahoa Village Rd., Pahoa, HI 96778
URL: Not Available
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NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2009/07/30 Approved on:
2009/07/11

Verified on:
2009/07/06 SHARON NELSON
1178 Kinoole St., Hilo, HI 96720-4133
Phone: 808-934-3244
Fax: 808-961-4795
Email: [email protected]
Type: CHC
ID: 1159991518
Sequence: 01
Score: 17
UDS: 09188C
PAHOA FAMILY HEALTH CENTER BAY CLINIC
(~ 32.83 miles away)
15-2866 Pahoa Village Rd., Pahoa, HI 96778
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NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2009/07/30 Approved on:
2009/07/11

Verified on:
2009/07/06 SHARON NELSON
1178 Kinoole St., Hilo, HI 96720-4133
Phone: 808-934-3244
Fax: 808-961-4795
Email: [email protected]
Type: CHC
ID: 1159991518
Sequence: 03
Score: 17
UDS: 09188B
KA'U FAMILY HEALTH CENTER
(~ 41.1 miles away)
95-5583 Mamalohoa Hwy, Na'alehu, HI 96772-0070
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NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2009/07/11 Approved on:
2009/07/11

Verified on:
2009/06/09 SHARON NELSON
1178 Kinoole St., Hilo, HI 96720-4133
Phone: 808-934-3244
Fax: 808-961-4909
Email: [email protected]
Type: CHC
ID: 1159991518
Sequence: 02
Score: 17
(Page 1 of 1)


UDS: 07117A
COMM HLTH CARE-MOLINE CLINIC
(~ 121.28 miles away)
1106 4th Ave., Moline, IL 61265-1231
URL: http://www.davchc.com
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NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2009/07/11 Approved on:
2009/07/11

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2009/07/22 GEORGE BARTON
500 W. River Dr., Davenport, IA 52801-1014
Phone: 563-336-3186
Fax: 563-336-3044
Email: [email protected]
Type: POP
ID: 117999170E
Sequence: 02
Score: 21
UDS: 052610S
V.N.A. HEALTH CENTER
(~ 125.91 miles away)
400 N. Highland Ave., Aurora, IL 60506-3814
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Physician - Primary Care
Obstetrics and Gynecology 2009/07/11 Approved on:
2009/07/11

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2009/03/18 TRACIE WOODS
400 N. Highland Ave., Aurora, IL 60506-3814
Phone: 630-978-2532 x8120
Fax: 630-978-2709
Email: [email protected]
Type: CHC
ID: 117999176K
Sequence: 06
Score: 17
UDS: 0526100
VISITING NURSE ASSOCIATION OF FOX VALLEY
(~ 125.91 miles away)
400 N. Highland Ave., Aurora, IL 60506-3814
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NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2009/07/11 Approved on:
2009/07/11

Verified on:
2009/03/18 TRACIE WOODS
400 N. Highland Ave., Aurora, IL 60506-3814
Phone: 630-978-2532
Fax: 630-978-2709
Email: [email protected]
Type: CHC
ID: 117999176K
Sequence: 08
Score: 17
UDS: 05328B
KOMED/HOLMAN HEALTH CENTER
(~ 147.01 miles away)
4259 S. Berkeley Ave., Chicago, IL 60653-3030
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NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2009/07/11 Approved on:
2009/07/11

Verified on:
2009/07/06 CHARLENE BIVENS
4259 S. Berkeley Ave., Chicago, IL 60653-3030
Phone: 773-268-7600
Fax: 773-268-9088
Email: [email protected]
Type: POP
ID: 117999178L
Sequence: 03
Score: 17
UDS: 056620
ALIVIO MEDICAL CENTER
(~ 147.64 miles away)
966 W. 21st St., Chicago, IL 60608-4511
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NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2009/07/11 Approved on:
2009/07/11

Verified on:
2009/06/25 EVELYN RODRIGUEZ
2355 S. Western Ave., Chicago, IL 60608-3837
Phone: 773-650-1203
Fax: 773-650-1226
Email: [email protected]
Type: POP
ID: 117999178Z
Sequence: 03
Score: 17
(Page 1 of 1)

UDS: 0116040
GYN OB ASSOCIATES
(~ 51.21 miles away)
373 New Boston Rd., Fall River, MA 02720-5814
URL: Not Available
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NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2009/07/11 Approved on:
2009/07/11

Verified on:
2009/06/15 JANICE SUNDNAS
373 New Boston Rd., Fall River, MA 02720-5814
Phone: 508-679-0911
Fax: 508-536-0310
Email: [email protected]
Type: POP
ID: 1259992560
Sequence: 06
Score: 17
(Page 1 of 1)

UDS: 0516820
MUSKEGON FAMILY CARE
(~ 87.65 miles away)
2201 S. Getty St., Muskegon, MI 49444-1207
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NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2009/12/01 Approved on:
2009/07/11

Verified on:
2009/07/01 CORA RUSS
2201 S. Getty St., Muskegon, MI 49444-1207
Phone: 231-737-1746
Fax: 231-737-1797
Email: [email protected]
Type: CHC
ID: 126999264T
Sequence: 07
Score: 19
(Page 1 of 1)


UDS: 043060
DBA BYHALIA FAMILY HEALTH CENTER
(~ 145.46 miles away)
12 E. Brunswick, Byhalia, MS 38611
URL: http://www.tnpca.org/hcenters/nemissclinics.htm
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NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2009/09/30 Approved on:
2009/07/11

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2009/06/19 MARJORIE MCKINNEY
P.O. Box 698, Byhalia, MS 38611-0698
Phone: 662-838-2163
Fax: 662-838-2100
Email: [email protected]
Type: SCTY
ID: 128093
Sequence: 03
Score: 19

UDS: 07129BN
ST JOHN'S CLINIC - ROLLA - OBGYN
(~ 47.95 miles away)
110 W. 10th St. # 140, Rolla, MO 65401-3248
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NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2010/01/01 Approved on:
2009/07/11

Verified on:
2009/07/28 CHRISTIE DRAPER
1100 W. 10th St. Ste 140, Rolla, MO 65401-2999
Phone: 800-535-9443
Fax: 417-820-7495
Email: [email protected]
Type: POP
ID: 1299992954
Sequence: 11
Score: 18
UDS: 071441E
COXHEALTH MONETT OB/GYN
(~ 127.4 miles away)
815 N. Lincoln Ave., Monett, MO 65708-1641
URL: Not Available
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NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2009/09/01 Approved on:
2009/07/11

Verified on:
2009/07/23 AMY LEA
3800 S. National Ave. Ste 540, Springfield, MO 65807-5284
Phone: 417-269-4420
Fax: 417-269-4349
Email: [email protected]
Type: POP
ID: 1299992958
Sequence: 05
Score: 17
(Page 1 of 1)
UDS: 061274B
NEO HEALTH - TAHLEQUAH HLTH CTR
(~ 143.28 miles away)
407 Daisy Dr. Ste A, Tahlequah, OK 74464-7370
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NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2009/09/01 Approved on:
2009/07/11

Verified on:
2009/05/05 AMY NOEAR
P.O. Box 751, Hulbert, OK 74441-0751
Phone: 918-772-3390 x114
Fax: 918-772-2244
Email: [email protected]
Type: CHC
ID: 1409994076
Sequence: 02
Score: 17
UDS: 061274C
OB/GYN AND ASSOCIATES
(~ 145.16 miles away)
1325 E. Boone St., Tahlequah, OK 74464-3361
URL: http://www.neochc.org
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NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2009/07/11 Approved on:
2009/07/16

AMY NOEAR
P.O. Box 751, Hulbert, OK 74441-0751
Phone: 918-772-3390 x114
Fax: 918-772-2244
Email: Not Available Type: CHC
ID: 1409994076
Sequence: 06
Score: 17
(Page 1 of 1
UDS: 04693C
BLACK RIVER HLTHCARE - KINGSTREE
(~ 67.26 miles away)
520 Thurgood Marshall Hwy # B, Kingstree, SC 29556-4108
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NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2010/07/01 Approved on:
2009/07/11

Verified on:
2009/07/02 VICKI CUSLIDGE
P.O. Box 578, Manning, SC 29102-0578
Phone: 803-433-1213
Fax: 803-433-6796
Email: [email protected]
Type: SCTY
ID: 145089
Sequence: 01
Score: 18

(Results 1 - 2 of total 2)
Site Information Category / Discipline / Specialty Projected Hire Date Dates Approved and Verified Contact Information HPSA Information
UDS: 12101601
ROSEBUD HOSPITAL
(~ 88.75 miles away)
400 Soldier Creek Rd., Rosebud, SD 57570
URL: Not Available
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NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2009/07/11 Approved on:
2009/07/11

MICHEAL BERRYHILL
801 Thompson Ave., Rockville, MD 20852-1627
Phone: 301-443-4242
Fax: 301-443-1071
Email: [email protected]
Type: IHS
ID: 1469994655
Sequence: 03
Score: 21
UDS: 12101501
PINE RIDGE COMPREHENSIVE HEALTH CARE
(~ 146.22 miles away)
East Highway 18 Box 1201, Pine Ridge, SD 57770
URL: Not Available
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NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2009/07/11 Approved on:
2009/07/11

Verified on:
2009/07/14 MICHAEL BERRYHILL
801 Thompson Ave., Rockville, MD 20852-1627
Phone: 301-443-4242
Fax: 301-443-1071
Email: [email protected]
Type: SCTY
ID: 146113
Sequence: 06
Score: 23
(Page 1 of 1)


NHSC Scholar
Physician - Primary Care
Obstetrics and Gynecology 2009/07/11 Approved on:
2009/07/11

Verified on:
2009/07/10 LENA RAGLAND
1469 Poplar Ave., Memphis, TN 38104-2934
Phone: 901-276-3222 x1010
Fax: 901-272-1109
Email: [email protected]
Type: POP
ID: 1479994706
Sequence: 03
Score: 18

 

[billyrickybobby]

They are not 2x the number of scholars.

Indeed, something doesn't quite add up here.


The requirement quoted in the federal register about their "obligation to identify approved service sites" of 1 but less than 2 positions for each scholar (I've been calling this the 1x-2x policy) seems fishy for several reasons... I'm not going to personally be at the scholarship conference next week, but I'd be interested in the answers to these questions:

• For the majority of scholars the min score has been at 14 for at least (I believe) 6 years, but the trend in number of scholars has been downward the whole time. How's that? Are there historical numbers that demonsratate they've been compliant this whole time (or is it a new statute?). (Unfortunately, even if they weren't compliant in the past it's hard to make the argument that they shouldn't be compliant now.)
• With the rolling process of clinics being added, removed, scores re-evaluated, etc. how is the 1x-2x policy administered?
• Does the policy take into account specific fields?
• What does "obligation to indentify" approved sites mean exactly? Are all sites with a given score identified, or are the numbers narrowed down to meet the 1x-2x policy? Can a scholar locate a clinic on their own? How can a simple score change really give the NHSC the granularity to strictly meet the 1x-2x requirement with the numbers of scholars getting so low (& getting lower)?
• How did/will the influx of money affect scholars? Aren't scholars indeed getting fewer choices and more competition this year? How does that make sense if the objective is for scholars to settle in their areas of service?

I was going to include a question about PPO (Private Practice Option)... but from a Google search of their site all the pages that used to mention PPO have been removed (I'm not sure when, but one of the pages is still cached in Google). Unless I'm mistaken, PPO was a program where you could choose any private practice in an underserved area that met certain requirements (mostly sliding scale). Interesting? I wish I had time to look into it further.
Safe travel to those headed to Tampa!

 

[billyrickybobby]

I haven't had time in a while to write another frantic, ranting post about the situation . My info has not changed-- the NHSC does seem to have the right to do what they're doing, though it's hard to find solid definitions of their obligations.

I'm looking forward to hearing from folks at the scholars conference next week. Hopefully the NHSC will have reasonable explanations for the change and treat their scholars well. Scholars are supposed to be the best of the best... they should honor the commitment and faith scholars place in the NHSC in kind.

With the demand for doctors & medical professionals skyrocketing, it seems to me that now is the time to demonstrate the value of the scholarship program in relation to the value of having employment options and open negotiation on graduation. With the number of scholars going down, they need to make some sort of adjustment or the situation will only get worse for scholars as years go by (even with the money for more scholars this year.)

Honestly, any graduate can choose to work in an underserved area if that's where their passion is. I'm yet to hear of anyone dropping out of medical school solely because they couldn't get the loans to finish. Loan repayment is common & is likely to be even more available as demand rises. Where's the value of the scholarship then?

So.. be careful, making the service commitment without the wisdom & contacts you gain during internship/residency is a substantial leap of faith... particularly right now with the declining # of scholars & uncertainty of a health care overhaul.

(On the other hand, maybe I'm missing something because applications are apparently 10x the scholar contracts awarded!)

 

[billyrickybobby]

One more thing-- someone at the conference please ask them to update their web site that still says:

Sites that have applied to and been approved by the NHSC post vacancies on NHSC Job Opportunities. Sites that list vacancies for scholars must be located in the neediest Health Professional Shortage Areas (this year, a HPSA score of 14 or higher, depending on discipline and specialty).

People are considering important career choices from this site, take a couple minutes to get it up to date!

 

[keithslc]

I told you the 2 to 1 ratio is misleading. They count all specialties combined. It doesnt have to be 2 to 1 for your specialty. So there are more OB-GYN applicants than there are openings as of now. I haven't gotten an answer on what they plan to do yet.

Have you ever gotten a reasonable answer from this organization?.. I havent in 5 years. They dont return phone calls and never answer there work phone.

 

[billyrickybobby]

I told you the 2 to 1 ratio is misleading.

Right -- misleading, impractical, and still it's the only reason they've specified for raising the minimum score. I'm interested in NHSC's explanation at the conference this week. I'm skeptical that the 2 to 1 ratio has been strictly followed in the past. As the number of scholars drops this will be a bigger problem.

I suppose the main question is if this year's scholars are going to get a raw deal with the NHSC focusing on the temporary flood of loan repayment money & not paying attention to scholars.

They'll have to address these issues in time... it's unfortunate that this year's scholars are getting caught in the gap.

 

[billyrickybobby]

Well, I'm hearing some answers from presentations at the scholars conference...

1-- Yes, they are intentionally limiting scholars to higher need sites to reserve the more attractive sites to lure loan repayment. They're totally focused on loan repayment this cycle, scholars just have to suck it up. Never mind that the ratio of loan repayment to scholars this cycle will be something like 30:1.

2-- Yes, the 1x-2x ratio statute is their only given rationale for raising the score and they refuse to discuss how it works in any detail so you can't verify what they're saying. But then they also say new sites are coming all the time, #1 above, and other things that indicate that they have discretion in this (which they certainly won't discuss).

3-- Yes, they are 100% unsympathetic. Don't like it? "Contact your congressman." (that's really a quote). From descriptions of the presentations, it sounds like the head of the NHSC is a pompous, hardened garden-variety bureaucrat hiding behind ambiguity and the allusion that he has no discretion. He won't acknowledge any accountability for how sloppily he is administering the program, the impact on scholars, or how poorly the NHSC is communicating the change to everyone involved. Their communication is so bad I heard some CLINIC REPS traveled to Tampa to meet scholars and weren't even told that the score change made their location ineligible, which made the trip a waste of their time.

I heard the first day a few scholars were literally crying in the hallways.

I accept this is the reality & unlikely to change this cycle... it's really unfortunate that they're being so disrespectful and combative with scholars. Maybe they'd do better to emphasize the role that these scholars have in getting more medical professionals into high-need areas and honor the sacrifice scholars are making to accommodate the opportunity with this freak flood of loan repayment money & be inclusive of scholars with all the good this will do.

Heaven forbid they actually pay attention to scholars & do ANYTHING to make the change easier on them.

Good luck new scholars, you can't say you weren't warned when your time comes!!

If you were there, please post your perspective.

 

[Siggy]

While changing the program after people have already entered is pretty low unless it was listed as a possibility in the contract you signed, come on and get over yourself. You knew when you signed up for the program that the entire purpose of the program was to get primary care physicians into areas of need. There's a reason why they paid for your medical school and now that it's time to meet your obligation, you're mad that they won't let you work where you want to. It's like someone complaining that the military is going to send HSPS students overseas coming out of medical school because that's where the military needs them.

As far as the different clinical score requirments, it makes sense. The students who went through the program since they entered medical school are a captive audience. Now they are trying to tap into the potential physicians that could help fill spots and, since those physicians have a choice, they have to sweeten the pot for them so that they can meet their goals.

Don't like it, don't sign on the dotted line. There's no such thing as a free lunch.

 

[billyrickybobby]

Don't like it, don't sign on the dotted line. There's no such thing as a free lunch.

The pompous, self-righteous medical student is such a rare breed-- but finishing with a cliché really makes your post a treat.

If you have a chance to read the thread, the bulk is about:

1) Warning people considering the scholarship about the trend, because the NHSC communicates so poorly.

2) Figuring out the rules this year in order to make the best of what everyone involved agrees is a particularly challenging time to be a scholar.

 

[Siggy]

Yea... and it'll be too soon before I see someone else with an entitlement attitude complaining that they aren't going to get everything for free. This entire thread smacks of "but I wanna practice here, but you won't let me."

Simple question. Did the contract you signed when you entered the program stipulate that HHS could change the need level? If so, sorry, you should have thought it out better. There's a reason why (besides the fact that I'm currently looking at EM which rules out NHSC) I'm avoiding the military scholarships and NHSC scholarships. Choice is an important thing and shouldn't necessarily be sold to the highest bidder, especially when that marker is called upwards almost a decade later. You signed the contract. You took their money. Now pay the piper.

 

[billyrickybobby]

You took their money. Now pay the piper.

Another cliché, brilliant. Really, the masterpiece cliché is the whole "doctor judging 'entitlement' in others" thing you have going. Unfortunately that indulgence tends to lead to a rather unsatisfying medical career.

It's refreshing to see someone courageous enough to offer their moralizing judgement unencumbered by their lack of knowledge or stake in the subject.

"but I wanna practice here, but you won't let me."

If you've read the thread & that's your summary then there's really nothing you can bring to the conversation. Everything you've said so far is either obvious or egotistical tripe. It takes a little more effort to contribute something useful.

 

[Siggy]

So, again (this time without the ad hominem attacks), was their ability to change the need level spelled out in the contract (assuming you read the contract, of course) that you signed? Yes or no will do.

...and I understand the stakes. The stakes are you basically get told a handful of high need areas that you will practice at to repay them paying for your medical school. Those areas are undeserved for a reason. I highly doubt that, say, Laguna Beach, CA is on the list of underserved areas.

 

[billyrickybobby]

was their ability to change the need level spelled out in the contract

It's that you're even asking this question that illustrates how much you're missing the point. Did you see anything in the thread that claims they're in breach of contract? Please do your own math to answer your own irrelevant question.

Sorry, without a reasonable understanding of the subject or personal stake in the outcome you have no credibility & your judgmental rant is misguided. This conversation would require granularity of thought finer than "there's no such thing as a free lunch" and "pay the piper."

To quote you, "come on and get over yourself"... discussing the impact of the change is constructive, particularly in this year of unusual circumstances. Your entire thesis is "I'm smart because I did something different. You should have done what I did." How constructive & inspiring. Talk about entitlement, exactly what kind of ego handout are you looking for?

I do appreciate that, in a backwards judgmental sort of way, you are serving one of the purposes of the thread-- to help people considering the scholarship understand the breadth of the commitment.

That's all I have for you, the orchard bears no fruit.

 

[hannah06]

Interesting discussion. I applied this year for the scholarship and have yet to hear anything (MSI). I researched the scholarship before I applied and knew it was a completely disorganized organization. It seems, however, that things have just gotten worse even since I have applied several months back.

How likely do you think that NHSC would implement more changes like this in the coming years? In other words, do you think that they will concentrate more and more on loan repayment in the coming years and phase the scholarship out all together? What do you think would happen to new scholars by the time they graduate? I'm hoping new leadership will come in soon and take care of this mess.

If I get the scholarship, I still plan on taking it. I'm in a situation where the financial incentive outweighs the risk of being stuck in an undesirable location 4 years. After all- I would still be practicing medicine and that's what we're doing this for. But it's certainly looking more and more like a roll of the dice.

 

[Siggy]

It's that you're even asking this question that illustrates how much you're missing the point. Did you see anything in the thread that claims they're in breach of contract? Please do your own math to answer your own irrelevant question.

The fact that you're admitting that they aren't in breach of contract signifies that this is nothing more than buyers remorse.

 

[billyrickybobby]

breach of conflict

"breach of conflict"... another carefully considered assertion. Fine work. Let it go, you've simply misunderstood this discussion.

 

[Siggy]

Sorry... breach of contract. Like you've never had a typo before.

 

[smq123]

Yea... and it'll be too soon before I see someone else with an entitlement attitude complaining that they aren't going to get everything for free. This entire thread smacks of "but I wanna practice here, but you won't let me."

Simple question. Did the contract you signed when you entered the program stipulate that HHS could change the need level? If so, sorry, you should have thought it out better. There's a reason why (besides the fact that I'm currently looking at EM which rules out NHSC) I'm avoiding the military scholarships and NHSC scholarships. Choice is an important thing and shouldn't necessarily be sold to the highest bidder, especially when that marker is called upwards almost a decade later. You signed the contract. You took their money. Now pay the piper.

While I understand your point, no one is really whining that they can't practice in Honolulu or Laguna Beach. It IS a frustrating change on many levels:

- The system for how need is determined is fairly inefficient. As KeithSLC pointed out, a region's HPSA score is determined by the sheer NUMBER of doctors....not which type. I can go into it more in depth, but suffice it to say for now that it's not a great system.

- The change in minimum HPSA score is a fairly big jump, from 14 to 17. Do you know how few sites qualify?

- The biggest gripe is how there is little information about this change. There was no warning, there was no discussion. The NHSC can't even seem to agree if the switch was made! The change in minimum HPSA score merely underlines the inefficient bureaucracy that characterizes the NHSC.

- It's also frustrating that there is so much preference given to the LRP. Do they want to keep this scholarship or not? If not, why faze it out by making the conditions undesirable? Why not just bite the bullet and shut down the program altogether?

There's nothing wrong with venting. It serves as a warning to others who are considering the scholarship, and it helps current scholars not feel so alone when they're blindsided by these changes.

 

[billyrickybobby]

How likely do you think that NHSC would implement more changes like this in the coming years? In other words, do you think that they will concentrate more and more on loan repayment in the coming years and phase the scholarship out all together? What do you think would happen to new scholars by the time they graduate? I'm hoping new leadership will come in soon and take care of this mess.

If I get the scholarship, I still plan on taking it.

The general trend in the number of scholars is downward (189 in 2004 down to 88 in 2009). I don't know if the reduction is a result of overall budget cuts at the NHSC or a shift from scholars to loan repayment... that would be one indication of their intent.

There will be a blip in the number of scholars next year (from what I've read) because part of the recovery act money has been set aside for new scholars. Various factors will have these new scholars graduating in 2-8 years so it seems to me the overall effect on field size will be small. The smaller the field size, the fewer sites available. As keithslc points out with Ob-Gyn, depending on your field the number of available sites could get very small. It will be interesting to see how they handle that shortage this year.

You sound at peace with accepting any location for 4 years & I'm confident you've read the excellent thread here for things to consider, so this isn't an issue for you. I'd say the biggest personal gamble with site location is the factors you can't control-- falling in love & spouse's employment options, family planning, a crisis with your extended family/parents, etc. For example, some sites are hours from a significant airport.

I have a theory (for what it's worth) that there's a "murky bottom" to the available sites that aren't realistic for anyone... unlivable for a variety of reasons, primarily salary vs. the cost of living & debts even a scholar has at graduation. The need level of these sites is off the charts because they aren't being reasonable with their terms and living conditions. Because of the 1x-2x statute, the smaller the number of scholars, the more scholars are submerged into that pool. As no one else would take these sites by choice, scholars will be the only ones forced to take them. The NHSC says sites are supposed to be competitive, the guidelines are lax & even they aren't enforced in any realistic way.

There does appear to be a general shift toward loan repayment. If this continues it will be a tightening squeeze on scholars as they graduate. This is complete speculation, but I'd say in 1-2 years after they've disbursed the $200M in recovery act loan repayment money they will have a fresh perspective on the merits of loan repayment vs. scholarships based on their success filling those 3,500 spots. A policy change in that timeframe seems possible but who knows in what direction.

To wildly speculate further-- the loan repayment will be perceived as a big success because of ARRA and they'll continue the trend, but no one will take the initiative to actually shut down the scholar program. The number of scholars will become comically small and they'll eventually have to lighten up the statute to allow scholars to access a wider range of sites.

IF there is some kind of universal health coverage by the time you graduate, the entire equation would be scrambled. Every facility will need more doctors any way they can get them & there will be a substantial increase in the capital involved in the health care business. In that environment I can't think of a scenario where someone would be glad to be a scholar (but there probably is one).

I suspect smq123 is better connected on this topic, I'm looking forward to their perspective.

I'd like to believe that conditions will improve in coming years but "roll of the dice" is right. Sincerely, good luck, I hope things turn out the way you want.

 

[235750]

So, again (this time without the ad hominem attacks), was their ability to change the need level spelled out in the contract (assuming you read the contract, of course) that you signed? Yes or no will do.

Siggy, do you rent a house or apartment?

If so, your lease almost certainly included a clause which gave your landlord the power to throw you out of your rented space over any sort of minor infraction (noise, dirty carpets, damaged walls, etc). I am a landlord so at any moment I could throw my tenants out on their bums. Would I do that to them? No, not unless they really screwed up. If I did throw people out for little stuff it would be within my legal rights, but it would be a really dick thing to do, and potential leasees would be correct to research my past behavior and avoid me like the plague

Like Billricky said, you really are missing the point of the discussion. Everyone knows with just about any contract, whether it's for rent or employment, that you basically sign away a good deal of your rights.

A big question for someone who is still considering the NHSC (like me) is, how common is this unfair exploitation of standard contract terms?

In this way, this thread has been extremely helpful. If the NHSC were a landlord, I would not currently rent from them

I highly doubt that, say, Laguna Beach, CA is on the list of underserved areas.

Your pompous attitude is incredible.

Look up scholar sites for psychiatrists in the state of NY. Then try NE, NJ, NH, MA, OH, VA, WV, OK, MA, MI and finally PA. You will only find two positions in prisons in PA that have any spots for scholars. Last year there were many more spots that qualified for the scholar program. The reduction in eligible sites and the difficulties that the new scholars face is important to my decision making process. Get it?

To everyone else: please ignore Siggy and continue to comment on any new developments with the NHSC. Thanks!!

 

[235750]

I'd say the biggest personal gamble with site location is the factors you can't control-- falling in love & spouse's employment options

This was my biggest problem. I talked over the phone with someone at NHSC to answer my questions about helping with spouse placement (also a soon to be doc). You see, the armed forces will even help with that. She said one could be placed as far as Guam. So then it would be nice if, lets say, your mrs. was an FM doc (like mine) and they could help get that person some part time work with them or some other group in the area (it is underserved right?). We don't care about money, so it could pay crap, we just wanted my mrs to be working and happy

But no, they wouldn't try to accommodate us at all. That, along with this thread and private messages sent to me from current/former scholars, convinced us not to apply for the scholarship, although we are thinking about the loan repayment program which of course does offer more control

Good luck! Let us know if you get the scholarship

 

[keithslc]

I think we need to try to organize NHSC scholars in order to have some sort of representation. As individuals we don't stand a chance but if we organize ourselves we can definetly have our voices heard. I feel we are being exploited after we sign on the dotted line. They have an open agenda to do with us as they see fit. There has to be some limits. I feel we should organize and goto the media with our cause. Especially with healthcare being in the fore-front at the moment.

 

[billyrickybobby]

I think we need to try to organize NHSC scholars in order to have some sort of representation

A scholar association would be great... with maybe $100 each from a reasonable percentage of scholars we could get something going. If it happened quickly it might even be effective for this cycle. An association could:

• locate a stakeholder (scholarship alumni?) to facilitate the association
  [*]encourage networking between scholars & alumni
  [*]act as a liaison between scholars & the NHSC
  [*]research & document processes, laws, history, etc. pertaining to the program. Interface with the NHSC, if needed use the freedom of information act etc.
  [*]monitor job listings & work with the NHSC to remove any invalid jobs... after all, they'd take the place of a valid one.
  [*]actively distribute NHSC news
  [*]manage web site, forums, email lists
  [*]provide improved online tools for matching scholars to sites
  [*]provide resources from a scholar's prospective to students considering the scholarship
  [*]organize a health insurance group for serving scholars... some sites have awful health benefits.
  [*]advocate for policy changes that might save the scholarship, or ultimately even advocate for closing the scholarship program if numbers continue to drop

If well managed, it could be a positive effort for everyone, even the NHSC itself.

If you know of likeminded people that want to organize something, please put me in touch with them!

A confrontational legal or publicity challenge would be difficult & I suspect unlikely to have an affect on the bureaucracy this year or any time soon. What is the basis of actual damages to scholars this cycle? It seems to me that conditions could be much worse & they'd still be within their legal & contractual rights. I do agree that conditions for most scholars this year are, by chance, tangibly worse than the past... I don't like it... but I can't quite say it's wrong.

 

[darksilkx]

You've done a great job researching this billyrickybobby. My wife's an OB GYN resident graduating next year and she was at the conference in Tampa. I've spent a ton of time in the last 4 months on the NHSC jobs site, calling primary care offices in tons on states, and calling health centers all over the country. I know that if we end up in some remote community, I'll probably not find a job - I work in Investment Management. The conference was a total waste of time and you pointed out most sites didnt know of the score change. My wife had an interview scheduled the Monday after the conference in a site that was a 15 when she applied in June. She decided to keep the interview since all the travel plans were made. Believe it or not, she had to tell the clinic director and staff during the interview that the score had changed - they didnt know. We are talking about a clinic with 7 locations and tons of staff in SOCAL.

I would advise prospective scholars to flee from this. The NHSC is dishonest, impolite, and they frequently misrepresent the program to hide its disadvantages. Plus they change scores when they want. Of course the breach penalties are insane. My wife's initial scholarships totalled about 170k. She asked the NHSC for a report stating how much she would owe if she decided to default on the service and repay the loan - 840 grand people!! Payable within a year of when she notifies them that she plans to default. Apparently they multiply the principal payments by three, and then start computing interest at an obscene rate from the date that the disbursement was made - when you were in med school hence the insane amount. With the benefit of hindsight my wife would never ever take the scholarship. Her classmates are signing private practice contracts for over 200k in a few cases which would help pay off school loans in a few years.

 

[darksilkx]

By the way not to start a stampede and please this is in no way authoritative. A HR person with a clinic my wife recently interview with called her today to say that she saw some NHSC memo today stating something about scrapping the use of HPSA scores and just letting scholars go to clinics with a need. I know what you're thinking, I thought it was absolutely rediculous too, and there must be a mistake. Until I remember reading a report on the NHSC on the recovery.gov website 4 months ago which assessed all government programs. The NHSC score "ineffective" if I remember. Is it possible Obama is trying to fashion the NHSC after his community service work where you make it easy for doctors to actually serve in their communities where they have a sence of belonging and obligation, and would actually stay once their repayment is up? Please let me know if you heard any similar rumblings.

 

[billyrickybobby]

A HR person with a clinic my wife recently interview with called her today to say that she saw some NHSC memo today stating something about scrapping the use of HPSA scores and just letting scholars go to clinics with a need.

Hmmmm... it's not April 1st...

My guess would be that it's most likely a misunderstanding & that the memo was referring to loan repayment, I've read before that they're going to keep lowering the minimum score for loan repayment sites as needed to use up the $200m recovery money.

Apparently at the conference they kept pushing the idea that it would take an act of congress to change the rules for scholars. Crazier things have happened, I guess, & you're right... it would make a lot of sense if they really intend scholars to permanently settle in their placement sites.

We'll see what develops.. can you imagine signing with a clinic & THEN having it change??

 

[alina_s]

Hmmmm... it's not April 1st...

We'll see what develops.. can you imagine signing with a clinic & THEN having it change??

Not that they can't or won't change the rules, but I think you're safe once you've submitted the contract to the NHSC and had them sign off on it. From what my analyst said (not that he's incredibly helpful), it is to your advantage to register all of your interviews on the BL Seamon travel web site even if you're not using the funds- he made it sound like registering the visit locks in the site's eligibility for you.

 

[billyrickybobby]

I heard there was an IHS memo in the last few days about minimum site score requirements being dropped for loan repayment. Apparently what's happening is that they are getting so many clinics wanting to be scored that they can't keep up. That memo said "loan repayment" right in the title... and the person that told me about it at first glance mistakenly thought that it applied to scholars, not just loan repayment.

HR person with a clinic my wife recently interview with called her today to say that she saw some NHSC memo today stating something about scrapping the use of HPSA scores and just letting scholars go to clinics with a need.

darksilkx, any chance your wife would give that clinic a call back & get more details on the memo? You can also PM me the contact info & I'll check it out.

once you've submitted the contract to the NHSC and had them sign off on it.

Hi Alina... darksilkx was saying that the NHSC might open up all sites to scholars regardless of score so I was thinking the opposite... if you compromised & signed with a site with a 17 score & then they lowered the score!! In that very unlikely case I believe you'd be SOL. I'm looking forward to hearing from someone that checks this out with the NHSC, it shouldn't take long to track it down.

 

[keithslc]

The location situation for scholars is misrepresented. It is not 2:1 as we have been led to believe. The NHSC needs to be exposed as to how losely they are run and how they mistreat scholars. They will not answer any questions, they misrepresent themselves, and they waste all their funds. Now is the perfect timing as the ears of everyone are open to helthcare right now.The situation for OB/Gyn placement could not get any worse as witnessed by my posting of sites. Now we have the funds to change this. I feel it needs to be noted how the govt is squandering the stimulus funds on people that are loan repayment physicians. The places that they offer loan repayment would staff without funds being offered. The money needs to be used to develop new sites. I would like to see an onlkine survey in this forum as to how many people would be willing to form a representative body. This is not just current students and residents but those employed currently need a voice. Why should they be happy with the way they are being pushed aside for loan repayment.

 

[BontaB]

This is my first contribution to this thread. I was happy to find it after I realized my choices for repayment have evaporated and to learn I am not alone. (I wasn't able to make it to the conference, so have been late to learn of the changes).
Multiple people have commented on organizing a group. I do feel we need to have a strong voice. I for one have already started letters to my senators, not that it will help but it's something. If anyone else wants to pursue this, please let me know. It seems as though quite of few people have done their research and been very thoughtful in their posts, we should use this to try to change our circumstances. As I said, it may not help but at least we'll have done what we could. Thoughts?

 

[keithslc]

Anyone want to volunteer to get this organization developed???

 

[BontaB]

I'd be happy to partner with someone to work on it. I'm a good work horse, but don't think I'm as strong on the history and facts as some others.

 

[dragonfly99]

This is sad.
I think that people who signed on earlier during med school for the NHSP should get their pick of the clinic/hospital sites that have need. Of course from the gov't point of view it is easier for them to give the better sites to people signing up for the loan repayment postresidency, b/c those people have a choice about whether to sign on the dotted line or not. I did IM residency and I am sure there are lots of clinics/neighborhoods that have high need, even within a reasonable distance of where most scholars would be willing to live. It is true that these scholars signed on the dotted line and have to take whatever the gov't dishes out, but how they are being treated just shows another reason why students and residents start out wanting to do primary care, but then change their minds.

 

[billyrickybobby]

I'd be happy to partner with someone to work on it. I'm a good work horse, but don't think I'm as strong on the history and facts as some others.

I've heard that someone at the conference announced their intention to organize scholars and they started collecting email addresses. I don't have contact information for them, I've kind of been waiting for them to pop up.

I also heard they handed out a list of contact information for all scholars in this placement cycle.

I nominate BillyRickyBobby! - Anyone want to volunteer to get this organization developed???

LOL, I'd be more than happy to help but I don't think I'm the right person to spearhead it. If someone has the contact information for the organizing scholar at the conference, it would be great to get in touch with them.

I'm completely with you Keith, if anyone has the basis for pushing back it's OB/Gyn. I think you're the closest of anyone to being able to claim that they're in breach of contract (though I'm hardly qualified to judge legally). At the very least I'd contribute to a legal fund for getting answers. I have to say my fear is that the NHSC is such a passive, headless organization that after a lot time & money you'd get to "oh, I guess you're right" and they might tweak the rules slightly. That's being pessimistic & my situation isn't as bad as yours.

Plan A for anyone really has to be to vigorously work the system as it stands... if plan B is to fight the system then more power to you!

 

[cali-ob]

Well, after multiple analyst changes, I finally spoke to my *new* analyst yesterday and she was actually really helpful. I felt like for the first time in 6 years, someone has actually explained the process of the "matching" and she verified that there are indeed many more site possibilities than the ones listed on the website. She also stated that the score could change for the better (for us) in each coming year, and that HPSA scores also can and do change. Overall I got off the phone feeling more informed and at least a little bit hopeful.