Primary Care scholarship or HPSP

[Sthpawslugger]

Have any of you been in the position of weighing whether or not to apply for a primary care scholarship for your state or applying for one of the HPSP scholarships? If so, how did you arrive at your decision? What internal and external factors led you to make a decision of choosing one versus the other? FYI, Ive read and understand the terms of each path, from COA cost covered to service requirements for accepting either.

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[DO2015CA]

Do neither cause you don't want to be pigeon holed into anything. Either specialty or post residency life. You don't know where you'll be in a decade. You can find repayment programs then.

 

[Sthpawslugger]

Do neither cause you don't want to be pigeon holed into anything. Either specialty or post residency life. You don't know where you'll be in a decade. You can find repayment programs then.

Thank you. I understand that some such as yourself would recommend against either;
however, I'm more interested in learning from people who have done one over the other.

 

[NontradCA]

Thank you. I understand that some such as yourself would recommend against either;
however, I'm more interested in learning from people who have done one over the other.

No one in med school is really going to know much about HPSP. There's an entire Military Medicine forum, but take what they say with a grain of salt.

 

[River Rat]

Since you think that the HPSP and the NHSC (that's the one you're talking about, correct?) are comparative, I'm assuming you're only doing it for money.

...Don't join the military. There are many reasons that compels someone to military service (other than, 'Murica, hard to believe but it's true,) money is not a good one. PM me if you wish.

Additionally, how deadset are you on primary care? You may feel a certain way now as a pre-med but may change your tune and wish you had left yourself the option to specialize in something else later on in your path. I am not familiar with the NHSC enough to speak to it but I would tread carefully, my friend.

 

[Sthpawslugger]

Since you think that the HPSP and the NHSC (that's the one you're talking about, correct?) are comparative, I'm assuming you're only doing it for money.

...Don't join the military. There are many reasons that compels someone to military service (other than, 'Murica, hard to believe but it's true,) money is not a good one. PM me if you wish.

Additionally, how deadset are you on primary care? You may feel a certain way now as a pre-med but may change your tune and wish you had left yourself the option to specialize in something else later on in your path. I am not familiar with the NHSC enough to speak to it but I would tread carefully, my friend.

Not doing anything for the money. Yet, as a late 30s male, with significant loan debt ahead, and likely not out of residency until ~45, I have to select a path that will help myself and family in the near future while keeping in mind unexpected life circumstances that may occur after. I can live like a resident for 5 or 6 years, but who's to say a dire situation doesn't arise where I end up living like a resident for another 5 or 6 beyond? I can live frugally, but want to fiancially stable. Read military page mucho times. Asked many people many questions...active, reserve, former enlistees, former milmed docs, active >20 yrs milmed physician, etc... Just thinking a lot. I appreciate your feedback btw.

 

[River Rat]

Not doing anything for the money. Yet, as a late 30s male, with significant loan debt ahead, and likely not out of residency until ~45, I have to select a path that will help myself and family in the near future while keeping in mind unexpected life circumstances that may occur after. I can live like a resident for 5 or 6 years, but who's to say a dire situation doesn't arise where I end up living like a resident for another 5 or 6 beyond? I can live frugally, but want to fiancially stable. Read military page mucho times. Asked many people many questions...active, reserve, former enlistees, former milmed docs, active >20 yrs milmed physician, etc... Just thinking a lot. I appreciate your feedback btw.

I recommend having this conversation with your partner. Are you sure you understand what being married to the military means? Are they okay with what being married to the military means? There will oftentimes be assignments that take you to remote parts of the world where you guys will a: be geographically separated from each other (hardship 365 tours), b: have nothing else to do but BE your spouse and raise your children. Some overseas assignments specifically prohibit military spouses from working due to the nature of the Visa that they get. If they are able to get employed, they often work on-base as a coffee barista, teaching at the elementary school, or other admin/secretary work. It takes a very special person to be okay with this. Are you sure that your partner will be absolutely okay with following you wherever you go, to do whatever needs to be done to make your marriage work and support your career? Are they okay with being in the middle of god knows nowhere giving up on their career? This scenario does not sit well for a lot of people, so it would be fair to include them in on the discussion.

It is fine to want to be financially stable. Dire situations happen all the time, I get it, but there are other factors in life that are more important than money. What's the point of being able to take care of your family should a catastrophe happen to you, if they hate you for it?

I'll say it again: Do not do it for the money.

I'm coming up on the end of my service obligation soon, and have no regrets. 4 years as a Flight Doc which I was pretty cool with, but I'm pretty balls to the wall as a person. I'm happy with my experiences (even despite being dealt some of the crappiest cards in terms of what can happen to you in the military) only because I did my research and was prepared for any which way the man can screw you. Some of the unhappiest people I've met in my situation are the people that did sign up just for the money. My only advice is for you to research what exactly it means to be in the military in the HPSP program and have honest dialogue with your spouse about what can happen should you go that route. There are only really several different fates: you may be permitted to do residency training right away after graduating medical school, in either civilian or a military program. Or they may ask you to be a general medical officer for a tour or two first, at which point you will fulfill your service obligation and GTFO and apply to civilian residency. Research all the little nuances into what those before you have found frustrating with the military.

As another option, I might recommend you looking into the FAP program that the military offers to see if that is something that better fits your needs. The perk of that being that since you sign up while starting residency training, you have a choice in a) specializing first, and b) location of where you pursue your training.

 

[67552931811]

I recommend having this conversation with your partner. Are you sure you understand what being married to the military means? Are they okay with what being married to the military means? There will oftentimes be assignments that take you to remote parts of the world where you guys will a: be geographically separated from each other (hardship 365 tours), b: have nothing else to do but BE your spouse and raise your children. Some overseas assignments specifically prohibit military spouses from working due to the nature of the Visa that they get. If they are able to get employed, they often work on-base as a coffee barista, teaching at the elementary school, or other admin/secretary work. It takes a very special person to be okay with this. Are you sure that your partner will be absolutely okay with following you wherever you go, to do whatever needs to be done to make your marriage work and support your career? Are they okay with being in the middle of god knows nowhere giving up on their career? This scenario does not sit well for a lot of people, so it would be fair to include them in on the discussion.

It is fine to want to be financially stable. Dire situations happen all the time, I get it, but there are other factors in life that are more important than money. What's the point of being able to take care of your family should a catastrophe happen to you, if they hate you for it?

I'll say it again: Do not do it for the money.

I'm coming up on the end of my service obligation soon, and have no regrets. 4 years as a Flight Doc which I was pretty cool with, but I'm pretty balls to the wall as a person. I'm happy with my experiences (even despite being dealt some of the crappiest cards in terms of what can happen to you in the military) only because I did my research and was prepared for any which way the man can screw you. Some of the unhappiest people I've met in my situation are the people that did sign up just for the money. My only advice is for you to research what exactly it means to be in the military in the HPSP program and have honest dialogue with your spouse about what can happen should you go that route. There are only really several different fates: you may be permitted to do residency training right away after graduating medical school, in either civilian or a military program. Or they may ask you to be a general medical officer for a tour or two first, at which point you will fulfill your service obligation and GTFO and apply to civilian residency. Research all the little nuances into what those before you have found frustrating with the military.

As another option, I might recommend you looking into the FAP program that the military offers to see if that is something that better fits your needs. The perk of that being that since you sign up while starting residency training, you have a choice in a) specializing first, and b) location of where you pursue your training.

I second all of this. I have family who are military docs and was able to speak with numerous upon numerous docs in the military (usuhs/ army/ navy/ air force/ contractors etc etc.) By and large, most LOATHED being a military doc. The ones who weren't were the ones who were previous military before med school or were usuhs grads. All the ones who did the hpsp for the money regretted it. Despite my military background and having loads of debt I declined my hpsp due to this. I really feel for all the young people I see on here and in my class who signed up because of the cursory appeal of it.

@Sthpawslugger , you really need to investigate this more. Don't talk to recruiters. Their job is to get you to sign up. They don't give two ****s about you. If you can somehow swing some convos with active mil docs then that is your best bet. As with anything with the military and government, READ the fine print and know exactly what you are getting into. At the end of the day, they OWN you: this cannot be understated.

I also endorse the FAP program. It's not well known and not advertised from recruiters because they get commission (i.e. they get promoted faster) based on how many people they sign up for the hpsp. The FAP program is fantastic. I would also look into contracting out once you are done with training. Another viable option to serve those who have given so much for this country while also protecting yourself and your future. Both of these options are far superior to the hpsp, imo.

 

[Staphylococcus Aureus]

SDN played a huge part in turning me away from HPSP for which I am grateful. The most important questions posed were are you willing to be an officer first and physician second? and would you join the military if you weren't a doctor? For me the answer to both was NO. If you say yes, HPSP may be a great deal for you.

 

[iceclimb12]

I second all of this. I have family who are military docs and was able to speak with numerous upon numerous docs in the military (usuhs/ army/ navy/ air force/ contractors etc etc.) By and large, most LOATHED being a military doc. The ones who weren't were the ones who were previous military before med school or were usuhs grads. All the ones who did the hpsp for the money regretted it. Despite my military background and having loads of debt I declined my hpsp due to this. I really feel for all the young people I see on here and in my class who signed up because of the cursory appeal of it.

@Sthpawslugger , you really need to investigate this more. Don't talk to recruiters. Their job is to get you to sign up. They don't give two ****s about you. If you can somehow swing some convos with active mil docs then that is your best bet. As with anything with the military and government, READ the fine print and know exactly what you are getting into. At the end of the day, they OWN you: this cannot be understated.

I also endorse the FAP program. It's not well known and not advertised from recruiters because they get commission (i.e. they get promoted faster) based on how many people they sign up for the hpsp. The FAP program is fantastic. I would also look into contracting out once you are done with training. Another viable option to serve those who have given so much for this country while also protecting yourself and your future. Both of these options are far superior to the hpsp, imo.

I am former military, non-medical, Infantry Officer and I agree with everything being said here. There are far too many physicians who are in the military for the money and they are not fond of their job, at all. They're not bad guys, but if you don't know what you're getting into this can be quite bad.

OTOH, military medicine can also be what you make of it. If you're a pretty hardcore dude/dudette, there are some certainly enviable opportunities. There are physicians who are Rangers, Special Forces, combat trauma surgeons, MEDEVAC flight surgeons, and more. But you have to do the (completely non-medical) schools, and be comfortable with being away from home a lot. That said, there are physicians comfortable with these things and love their work.

I also opted against taking a HPSP, despite my background. I didn't really see myself being the doctor I want to be, and for any amount of money being unhappy there isn't great, and at worse can endanger others. I could have done some of the cool stuff, given my background, and not have to attend some of those Army schools, but it just didn't feel right. It's a big, important commitment to make, and if you are unsure, it may be better to avoid giving your life over to Uncle Sam.


Sent from my iPad using SDN mobile

 

[Sthpawslugger]

Thank you all for commenting here in response to my original post. Aside from reading this and the military medicine threads, I've spoken with numerous former non-medical and medical as well as some active non-medical and medical over the past 2 weeks. Also chatted with some FM physicians...

I decided against applying for my state's primary care scholarship/loan program. I could see myself doing FM for the short-term, but not duration of my medical career, which at my current age of 36, would be roughly 25 to 30 years, assuming I'm able to work until 70.

I cannot apply for the Army as my MCAT falls under their minimum requirement. Same for AF. I don't know if AF would use my medical school grades next year if I decided to apply for the 3 yr HPSP...

It's to my knowledge I can apply for Navy HPSP. I've spoken with an AD Navy ortho who offered a lot of insight to help me understand how the process works and what I'd be signing up for should I choose this route. I''m not adverse to doing a yr of GMO necessarily; however, from the several posts on SDN and off, I've come to the conclusion that it can turn into a 2nd GMO tour. I understand ortho is highly competitive and am prepared to chew bubblegum and kick a** on my way to reaching my goal of landing an ortho residency spot(over the years, I've worked in sports medicine, the ER, cardiology, outpt ortho, even a little GI research, so I really know what I want to do). Yet, with graduation at 41, and a GMO to follow, should I for some reason or another not match due to a heavy, highly competitive applicant pool combined with luck of the raw, I would be unhappy having to postpone entering ortho residency for another year, or not matching into ortho for that matter. If I knew without a doubt that one GMO would be it, I'd be more confident in taking that next step.

On a side note, I had a conversation with a dear friend of mine of 25+ years, who is very financial-minded, even moreso with his degree in Finance. What it came down to from his perspective is do I want to give up my freedom to serve and be debt free, or have freedom but be half a million in debt. I hate debt. Again, not proud of being irresponsible and nearsighted with past student loans. So yes, that has been a motivating factor for applying HPSP. Also, I've wanted to do and experience much in life, as I say, I regret that I have one life to live. Why not say sacrifice a few years of my live serving those who defend our country? Money is insignificant to me such as long as I can provide for my family and live a good, humble life. Yet, due to my outlined concerns in the earlier paragraph, paying off loans aggressively once I enter ortho practice is the likely route.

 

[DO2015CA]

One could argue that if you land ortho that it would be financially irresponsible to do milmed. If you work like a dog you can have your half a million in debt gone in 2 years.

 

[Gastrapathy]

No one in med school is really going to know much about HPSP. There's an entire Military Medicine forum, but take what they say with a grain of salt.

What specifically should be taken with a grain of salt?

 

[deleted480308]

What specifically should be taken with a grain of salt?

I'm also interested in this answer

 

[NecrotizingFasciitis]

I went through the entire application process for HPSP and decided not to do the scholarship. As a brief background: I met with my recruiter many times in person, spoke with current medical students in HPSP over the phone, through e-mail, at medical school interviews, and through SDN about HPSP. I also spoke with family and friends who have served/currently are serving in the military and concluded this:

HPSP is a great idea for those who:
a.) Know exactly what they are getting into (previous armed forces experience, close family/friends in armed forces, etc.)
b.) Genuinely want to serve the country. The key word is genuinely.

As @River Rat mentioned, doing it for the money is NOT the correct reason to commit to this program. And as @DO2015CA mentioned, it can pigeonhole you into a limited number of areas of medicine (eg: if the military doesn't currently need a neurosurgeon, there won't be a residency spot for a neurosurgeon, and you can't become a neurosurgeon.)

For me, the main reason I decided to withdraw my application (among others) was because I personally don't know where I will be 4 years from now; I don't know what area of medicine I will want to go into. Further, I don't know where I'll be 7-10 years down the road when I finally finish training. Maybe I'll have a family and kids and won't want to move around a lot for deployment? Maybe I'll end up in a lucrative area of medicine and won't necessarily have to worry about debt as much? Etc.

Despite feeling a genuine desire to give back to the country, I feel like I don't know enough about my future (and also the ins/outs of being in the armed forces) to commit to a program that will have me paying back my school debt (starting) 7-10 years down the road from now. If this seems to resonate strongly with you, I recommend looking into the F.A.P. (financial aid program) which can be through army, navy, or air force. This program is one you apply to after you have already matched into residency, so it doesn't pigeonhole you into a specific area of medicine, and it allows you time to figure out where you will be in life when you actually start paying back your debt.

The downside of FAP? You dont' get the financial stability DURING medical school that the HPSPers will. BUT you get 100% freedom to choose a medical specialty and you get more time to think about whether the armed forces might be a good idea for you.

Hope this helps, and congrats on your acceptance future doc!
-NF

 

[NontradCA]

What specifically should be taken with a grain of salt?

Anything you post on there.

 

[Gastrapathy]

Anything you post on there.

OK. Find one post of mine that is false. Should be easy. There's 3000+ to choose from.

 

[NontradCA]

OK. Find one post of mine that is false. Should be easy. There's 3000+ to choose from.

Cool story. I'd do that if I cared enough. I thought you caught on to my first response. Have a good week though.

 

[Electric Head]

DON'T DO IT.

For HPSP, there is a good chance you will not be matched into a military residency, and will be forced to to a GMO tour. GMO tours can last years, but the deal killer is is: the active duty years you owe after a GMO tour will be however many years left you owe (minus the GMO years) or however many years you have left in residency, whichever is longer. This means that if you had your heart set on general surgery, you could be in for 7 years total making ~ $150k when you could have been making attending pay.

For the primary care fast track, you don't know you want to do FM or won't know that until you're doing rotations.

Edit: since you're so worried about debt, know that it is very common to negotiate debt repayment from hospitals or community groups. This is especially true for rural areas (which pay more be salary and bonuses than urban on top of that). I've heard of sign on bonuses of of over $100,000. Also, if you do primary care, most states have debt forgiveness programs that knock off $25k per year.

Don't worry about the debt. Even if you get none of these, you can pay off all of your debt yourself within 3-4 years if you live like a student. Let's use a base pay of $300,000 (doctor pay is going up in primary care, so in 7 years it should be near this number). You graduate with $300,000. So 300k minus 50% in taxes minus 40k for living expenses minus 20k malpractice = 90k leftover. Taking interest into account, you're looking at 3-4 years of debt repayment. If you don't take advantage of any sign on bonuses or debt forgiveness incentives.

 

[Pat_2016]

I second all of this. I have family who are military docs and was able to speak with numerous upon numerous docs in the military (usuhs/ army/ navy/ air force/ contractors etc etc.) By and large, most LOATHED being a military doc. The ones who weren't were the ones who were previous military before med school or were usuhs grads. All the ones who did the hpsp for the money regretted it. Despite my military background and having loads of debt I declined my hpsp due to this. I really feel for all the young people I see on here and in my class who signed up because of the cursory appeal of it.

@Sthpawslugger , you really need to investigate this more. Don't talk to recruiters. Their job is to get you to sign up. They don't give two ****s about you. If you can somehow swing some convos with active mil docs then that is your best bet. As with anything with the military and government, READ the fine print and know exactly what you are getting into. At the end of the day, they OWN you: this cannot be understated.

I also endorse the FAP program. It's not well known and not advertised from recruiters because they get commission (i.e. they get promoted faster) based on how many people they sign up for the hpsp. The FAP program is fantastic. I would also look into contracting out once you are done with training. Another viable option to serve those who have given so much for this country while also protecting yourself and your future. Both of these options are far superior to the hpsp, imo.

Thank you so much for your advice! I am in the same boat and swaying from HPSP because I told by my interviewer that I could potentially end up serving up than four years of active duty if I don't get into a residency program right away. I am 27 and starting a family in my 30's is important to me.

 

[8404HMFMF]

Being an officer first, and physician second is big. My battalion surgeons that I worked under (Navy) practiced medicine ON BEHALF OF THE COMMANDING OFFICER. Thus your medical opinion is just that, an opinion. Granted most good Commanders would listen to the physician but there were times where they were completely disregarded. I enjoyed my time in the Navy and feel that Naval medicine is top notch, especially on the battlefield. Like you, I'm now in my 30's and debt or not, I will not let anyone control the future of my career the way that the military, especially the Navy can. There are plenty of debt repayment programs, signing bonuses and other things to help you out once you get there.

 

[Armyhealth]

I second all of this. I have family who are military docs and was able to speak with numerous upon numerous docs in the military (usuhs/ army/ navy/ air force/ contractors etc etc.) By and large, most LOATHED being a military doc. The ones who weren't were the ones who were previous military before med school or were usuhs grads. All the ones who did the hpsp for the money regretted it. Despite my military background and having loads of debt I declined my hpsp due to this. I really feel for all the young people I see on here and in my class who signed up because of the cursory appeal of it.

@Sthpawslugger , you really need to investigate this more. Don't talk to recruiters. Their job is to get you to sign up. They don't give two ****s about you. If you can somehow swing some convos with active mil docs then that is your best bet. As with anything with the military and government, READ the fine print and know exactly what you are getting into. At the end of the day, they OWN you: this cannot be understated.

I also endorse the FAP program. It's not well known and not advertised from recruiters because they get commission (i.e. they get promoted faster) based on how many people they sign up for the hpsp. The FAP program is fantastic. I would also look into contracting out once you are done with training. Another viable option to serve those who have given so much for this country while also protecting yourself and your future. Both of these options are far superior to the hpsp, imo.

Did he just say we get promoted faster and commission haha. I am still waiting on my promotion then. I put 14 into AMEDD last year and on the pace for more this year including two OMFS, one Ophthalmologist, two family practice and one surgeon. No promotion, no bonus...I did get a nice wall hanging. Also FAP is given case by case for the Army they have gone away from FAP. Maybe you mean STRAP?

 

[River Rat]

I believe he means the recruiters get commission via form of faster promotions based on number of people they recruit. Which I haven't a clue about.

 

[ortnakas]

For people who want to be in the military as their career (or as a major part of it), HPSP is a great choice. As simply a way to pay for med school, it's a bad choice.

As far as the primary care goes-- do some soul searching and decide if there is a 100% chance you won't fall in love with surgery or some other specialty. Those programs are a great choice for some, but can be problematic if you're in a binding contract but discover you loathe clinic (I believe some primary care programs are binding and others will let you out albeit with a penalty-- do your homework).

 

[iceclimb12]

I believe he means the recruiters get commission via form of faster promotions based on number of people they recruit. Which I haven't a clue about.

It would only be in the form of positive, quantitative NCOER bullet points... not necessarily faster promotion, but it definitely helps when you go to promotion board.

I think OP has a good answer, HPSP = great if you want to be in the military, bad if you just want money. Primary care = great if you 100% want primary care.