Resigning HPSP?

[AF HPSP]

I've been seeing a lot of posts on the inefficiencies and abuse some people have suffered as an air force doc. I originally joined to serve my country, the money was just a bonus. Now I am starting to have serious doubts about my decision, and would have preferred to join after residency as some of the posts (island doc, mil med, etc.) recommend so that i would not be restricted in residency choices or location.

It is a bit late for me, as I am already in the HPSP, so I was wondering if I wanted to go civilian, if there was any way of getting out of the HPSP. Can you just pay back what you owe or will you be forced to serve as a line officer, or even court-martialed?

I appreciate any info you might have on resigning a commission or HPSP. Is that something possible/feasible?

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[island doc]

I've been seeing a lot of posts on the inefficiencies and abuse some people have suffered as an air force doc. I originally joined to serve my country, the money was just a bonus. Now I am starting to have serious doubts about my decision, and would have preferred to join after residency as some of the posts (island doc, mil med, etc.) recommend so that i would not be restricted in residency choices or location.

It is a bit late for me, as I am already in the HPSP, so I was wondering if I wanted to go civilian, if there was any way of getting out of the HPSP. Can you just pay back what you owe or will you be forced to serve as a line officer, or even court-martialed?

I appreciate any info you might have on resigning a commission or HPSP. Is that something possible/feasible?

Not much chance. I tried to go Palace Chase after having served part of my ADSC, and was denied because AFHPSP is a "high cost" program, so the chances of you being released from the obligation you have incurred is very unlikely.

I do recall some physicians trying to payback the money instead of doing the time, and they too were rejected, presumably because the AF needed the services of a physician more than they need the money.

There have been some military physicians who have refused to be deployed to combat and have in fact been court-martialed, so if you were to default on your contract it is quite possible that you could be put on active duty, arrested and court-martialed.

My advice to you is this: Try to make the best of your situation given the fact that it is not reversible. (Make Lemonade out of the lemons.) Make yourself as competitive as possible in order to be in the best possible position when the time comes to apply to the JSGME board, and hope for the best. Worst thing is you could spend your entire time as a GMO as I did.

Very unlikely that they would accept your resignation of commission.

We in this forum try to intervene before someone signs the contract, receives the funds and obligates themselves , but since you already have, you just have to try to make the best of it at this point. Sorry.

 

[coolslugs]

I've been seeing a lot of posts on the inefficiencies and abuse some people have suffered as an air force doc. I originally joined to serve my country, the money was just a bonus. Now I am starting to have serious doubts about my decision, and would have preferred to join after residency as some of the posts (island doc, mil med, etc.) recommend so that i would not be restricted in residency choices or location.

It is a bit late for me, as I am already in the HPSP, so I was wondering if I wanted to go civilian, if there was any way of getting out of the HPSP. Can you just pay back what you owe or will you be forced to serve as a line officer, or even court-martialed?

I appreciate any info you might have on resigning a commission or HPSP. Is that something possible/feasible?

Also, remember not to regret your decision just because of the opinions of few other people. You need to find both sides of the story before you decide.

 

[island doc]

Also, remember not to regret your decision just because of the opinions of few other people. You need to find both sides of the story before you decide.

What "other side"?

 

[IgD]

Take everything you read on here with a grain of salt. If you can be flexible and have a positive attitude you will have a successful career (even if just for your obligation) in the military. You will have days you want to get out ASAP but most of the time you will be happy.

If you go in with a bad attitude you will get labeled as such as people will make your life miserable.

 

[island doc]

Take everything you read on here with a grain of salt. If you can be flexible and have a positive attitude you will have a successful career (even if just for your obligation) in the military. You will have days you want to get out ASAP but most of the time you will be happy.

If you go in with a bad attitude you will get labeled as such as people will make your life miserable.

That's right take this (above) with a grain of salt.

It might surprise you to learn, that initially I did actually go into the AFMS with enthusiasm, excitement, and a positive attitude, with hopes for a long and successful career, but all this was slowly but surely destroyed as the result of the organization's deliberate suppression of my professional medical career goals and aspirations.

Don't forget also, there really cannot be any truly accurate comparisons made between the Air Force Medical Service, the Navy Bureau of Medicine and Surgery, and the Army Medical Department, because they are all separate and distinct organizations. Listen to those who have experience in the branch of service that applies to you.

 

[USAFdoc]

Take everything you read on here with a grain of salt. If you can be flexible and have a positive attitude you will have a successful career (even if just for your obligation) in the military. You will have days you want to get out ASAP but most of the time you will be happy.

If you go in with a bad attitude you will get labeled as such as people will make your life miserable.

IgD, it amazes me that you continue to dismiss the experiences of those that have been right there "on the front line" as "just a grain of salt", and that it must be that "they have bad attitudes" and "you will be happy most of the time" if you just keep a good attitude.

In my 40 years of life, many jobs including Navy and USAF as well as civilian jobs I have always had a good attitude, work ethic, and strived to serve others and be the best at what I do. I have NEVER, EVER, EVER, seen anything like what I experienced first hand in the USAF these past 3 years. And in speaking PERSONALLY to many many docs across the USAF during the last 3 years, 100% (100%, 100%) have had similar experiences and have similar opinions as to the state of military medicine .....it is VERY broken; it is getting worse, and all are leaving asap.

My current job is wonderful. My multiple jobs before the USAF were fine to wonderful. I have been recocnized as a teacher of the year, I have been involved with Big Brothers/Sisters for 20 years, ...I am all in all an ok guy who has a positive outlook on life. It just so happens that the USAF has an incredibly BAD way of designing and manning a health care system and it is getting worse (for patients and staff) so all are leaving. It is that simple.

So, yes, have a good attitude, but call a spade a spade, and a terribly poor health care system what it is.

It is in your interest and that of your family for you to stay away until the USAF is committed to delivering on what they advertise, or at least something close. Currently it is a sham, and a shame.

 

[IgD]

IgD, it amazes me that you continue to dismiss the experiences of those that have been right there "on the front line" as "just a grain of salt", and that it must be that "they have bad attitudes" and "you will be happy most of the time" if you just keep a good attitude.

I appreciate some of the things you and Island Doc say. However you guys have s___ colored glasses. Nothing will ever change that. Please try to have a more balanced perspective.

When you guys come on here every day and bash the military and try to dissuade people from joining you are:
1. Hurting the people (young warfighters) who need medical care the most
2. Hurting our country
3. Hurting yourself

The military isn't for everyone. Obviously it wasn't for you. Get on with it and help the people that it is a good fit for.

 

[USAFdoc]

I appreciate some of the things you and Island Doc say. However you guys have s___ colored glasses. Nothing will ever change that. Please try to have a more balanced perspective.

When you guys come on here every day and bash the military and try to dissuade people from joining you are:
1. Hurting the people (young warfighters) who need medical care the most
2. Hurting our country
3. Hurting yourself

The military isn't for everyone. Obviously it wasn't for you. Get on with it and help the people that it is a good fit for.

In Reply;

1) about the s___ glasses: I hope neither one of us has "glasses" on. I am just letting people know what I have seen first hand. People like you can have no idea what has been going on there in the clinics. There is a reason that 8/9 civilian docs and 100% civ nurses quit/left my clinic during the last 3 years and why 100% of docs left at their first date of separation. You seem to think the more logical explaination is that none of these people were "cut out" for military medicine. I strongly beleive the problem is that the military is currently "not cut out" to operate a primary care clinic correctly.

2) Dissuading people from joining the military "hurts" everyone; well, lets look at this. As things stand (the way the military is running things), the military is causing alot of hurt.....nearly 100% of new docs calling it quits to military clinical careers, extreme undermanning of clinics "burning out" clinic staff, preventable adverse outcomes and numerous nears misses as a result of a terribly designed health care plan, and the USAF hurting itself as they are losing people that initially joined as motivated career docs who have much to offer the USAF.........I beleive things will not get better until the endless pipeline of unsuspecting med students is curtailed. Until then, the USAF will have to supplement the missing docs with civilian docs who will not put up with terrible clinics, or they will leave (which they frequently do). This is force the USAF to change or completely civilianize the whole situation (which I beleive will be the end result).

3) "The military obviously wasn't for you"........well IgD, please tell me who it is for? What physician is going to accept:

1)20% manned clincs
2)20% chart availablity
3)admin techs shredding paperwork rather than filing it.
4)a pile of unfiled labs results, etc over 18 feet high.
5)having 100% responsibility and ZERO % authority.
6)more and more referral docs wanting nothing to do with TRICARE patients because of the less than MEDICARE reimburement rate.
7)"real" panel sizes 2-3 times that of our civilain counterparts.
8)Admin that focus' exclusively on METRIC numbers, numbers that are frequently innaccurate and falsified by admin to "look good".
9)working 12+ hours a day and being told it just isn't good enough.
10) Being threatened to "hush" about clinic problems.
11) Having pay (bonus') withheld, or threatened to be withheld on the whim of admin.
12) Read othr threads for more.


Good luck in your career IgD. I hope things are better by the time you arrive at the front lines, but you have no idea of the level of incompetence that may await you when you get there. "suck it up" and "get it done" are great mottos, and I support them...but missing in all your threads is the point that the USAF bears a responsibility to provide a clinic environment that at least provides the basic "material" and "support" to operate a clinic safely. If they want to call all the shots, then that is their responsibility, and what I saw for 3 years was a clinic that was run UNSAFELY, and RECKLESSLY at times.

Like I said, USAF primary care is currently a SHAM and a SHAME.

 

[IgD]

This reminds of the book Chicken Little. THE SKY IS FALLING! THE SKY IS FALLING! I was doing a search once on military medicine and found a post similar to the one you just made. The funny thing was the date was from the late 1990's. The military and its medical system have been around a very long time and will continue to be around in the far future.

 

[AF HPSP]

I appreciate all of your input. Obviously there is a lot of disagreement on the state of things in the military, but I have seen and talked to people who agree with islandoc's and USAFdoc's comments on the state of things. I think that their suggestion of joining after residency is the best compromise, because then you can not only be guaranteed your residency choice, but also have a greater influence on where you get stationed and what the staffing and ancillary services are like at that place. And you still get to serve just as you would have doing the HPSP. I am feeling at the mercy of the AF at this point, since I am competing for a highly competitive field, and although I have several interviews lined up at top institutions for the civilian match, they can just turn around and say that i cannot go into my specialty of choice. I am going through a lot of Pepcid at this moment just thinking about getting assigned to a specialty I did not choose or care to go into, in a location I do not want to be in, and with decreased chances of matching at a civilian program after I am done simply because I would be no longer applying straight out of school. I hope not too sound too pessimistic, but the truth is that I feel cornered and completely at the mercy of the AF despite having a good resume and be almost guaranteed a civilian residency in my specialty at a top program. I am still enthusiastic about serving my country and helping those in uniform, but I just wish that I could do so in a specialty of my choosing (as the recruiters guarantee). Again I appreciate all of your opinions on this forum, and whether positive or negative regarding AF medicine they have helped me gain a better understanding of what lies ahead. Best of luck to all!

 

[FliteSurgn]

Again I appreciate all of your opinions on this forum, and whether positive or negative regarding AF medicine they have helped me gain a better understanding of what lies ahead.

I added the underlining because that is what you can expect.

 

[coolslugs]

Does all this only affects medicine, or the whole AF health system (optometry, pharmacy, dental etc.)? Does anyone know?

 

[island doc]

This reminds of the book Chicken Little. THE SKY IS FALLING! THE SKY IS FALLING! I was doing a search once on military medicine and found a post similar to the one you just made. The funny thing was the date was from the late 1990's. The military and its medical system have been around a very long time and will continue to be around in the far future.

IgD's opinion is a hopeless, lost cause. His or her mindset is not going to change. If he or she wants to walk off the cliff, so be it.

 

[island doc]

Recruiter's "guarantee"??? Now that's an oxymoron. The only things "guaranteed" are what is explicitly written in the contract, which should be reviewed by your attorney before you even think of signing it.

 

[island doc]

Recruiter's "guarantee"??? Now that's an oxymoron. The only things "guaranteed" are what is explicitly written in the contract, which should be reviewed by your attorney before you even think of signing it.

 

[AF HPSP]

Recruiter's "guarantee"??? Now that's an oxymoron. The only things "guaranteed" are what is explicitly written in the contract, which should be reviewed by your attorney before you even think of signing it.

seriously... i wish i could go back in time and change that...

 

[R-Me-Doc]

This reminds of the book Chicken Little. THE SKY IS FALLING! THE SKY IS FALLING! I was doing a search once on military medicine and found a post similar to the one you just made. The funny thing was the date was from the late 1990's. The military and its medical system have been around a very long time and will continue to be around in the far future.

Yep. Ten years and NO IMPROVEMENT. What does that say for the state of military medicine? Sure "it will continue to be around," but that doesn't mean it's going to be good . . .

RMD 0-8-8

 

[coolslugs]

Does anyone know the answer to my question?

 

[grayce79]

AFHPSP

I too had many of the same concerns that you have after reading this forum. I pulled out my contract and it states explicitly that just because you are willing and/or able to pay back the money does not release you from your agreement.
I also "googled" for people who quit HPSP. I found one person who was a conscientious (sp?) objector who offered to pay all of the money back plus interest. He was court martialled and spent three days in jail.
It's funny because all of my friends said they thought 3 days in jail would be worth it, but I figured if it would be a lot worse for someone whose reason for wanting to resign is just "I read on an online forum that says military medicine sucks" or "my recruiter was full of crap".
Anyways, after I rotated at a couple of AF hospitals, I felt a lot better about military medicine. (I've been flamed before for saying this because I'm "just a med student and I couldn't possibly know what good patient care is...blah, blah, blah")
People everywhere are miserable. Every hospital I have ever worked at has a few people who spend the majority of their lives complaining about how horrible their lives are.
Although I think this forum is great for people who are thinking about hpsp, it can be just discouraging for the rest of us who are already stuck!
Just know you aren't the only one!

 

[USAFdoc]

This reminds of the book Chicken Little. THE SKY IS FALLING! THE SKY IS FALLING! I was doing a search once on military medicine and found a post similar to the one you just made. The funny thing was the date was from the late 1990's. The military and its medical system have been around a very long time and will continue to be around in the far future.

who said all of military medicine is ending? You seem to have a knack of misrepresenting things. I am saying that the primary care platform of the USAF is badly broken, and I expect it to be mostly civilianized within 5 years. That is already happening as we speak. The base I worked at now has 4 more civilian doctors (but only had 1 military doc left seeing patients and one deployed).

and you never seem to be able to defend the problems I bring up (lists of problems); likely because you have no experience and there is no excuse to run a clinic that poorly. YOU, IgD are the perfect unsuspecting "med student knows best", but even you will change your mind given a taste of USAF primary care brew.

 

[coolslugs]

I am saying that the primary care platform of the USAF is badly broken, and I expect it to be mostly civilianized within 5 years. That is already happening as we speak. The base I worked at now has 4 more civilian doctors (but only had 1 military doc left seeing patients and one deployed).

What are your recommendations to fix this problem?

 

[AF HPSP]

AFHPSP

I too had many of the same concerns that you have after reading this forum. I pulled out my contract and it states explicitly that just because you are willing and/or able to pay back the money does not release you from your agreement.
I also "googled" for people who quit HPSP. I found one person who was a conscientious (sp?) objector who offered to pay all of the money back plus interest. He was court martialled and spent three days in jail.
It's funny because all of my friends said they thought 3 days in jail would be worth it, but I figured if it would be a lot worse for someone whose reason for wanting to resign is just "I read on an online forum that says military medicine sucks" or "my recruiter was full of crap".
Anyways, after I rotated at a couple of AF hospitals, I felt a lot better about military medicine. (I've been flamed before for saying this because I'm "just a med student and I couldn't possibly know what good patient care is...blah, blah, blah")
People everywhere are miserable. Every hospital I have ever worked at has a few people who spend the majority of their lives complaining about how horrible their lives are.
Although I think this forum is great for people who are thinking about hpsp, it can be just discouraging for the rest of us who are already stuck!
Just know you aren't the only one!

thanks grayce79, that makes me feel a little better. guess i just need to suck it up and try to make the best out of it now that there's no turning back. if i could match in my specialty of choice i'm sure it wouldn't be that bad because at least i'd be doing what i like, i just dread getting stuck doing something i really do not care for. good luck w/ med school, and good luck with the match (guessing you're a 4th year)!

 

[militarymd]

What are your recommendations to fix this problem?

Make administrators listen to doctors.....In the civilian world, the hospital adminstrators ask the doctors what they want and give it to them.

 

[rbear]

To get back to the question AF HPSP originally posted....I actually made the mistake of joining Army HPSP but haven't gone to OBC, no ADT, or any other training. I've just been in the program for a few months and already I know it's not for me, mainly because I've come to realize clinical medicine is NOT for me. It's not a question of money, just what role I want my education to play in my life. I've realized that I simply love to teach and do research. I don't want to bring anyone the worse news of their lives or tell them that they're time on earth is limited. What time I've had in the clinical setting already seals the deal for me. So what do I do now? I heard of a guy (classmate of a friend at another school) in a similar situation as mine. He tried to resign for many of the same reasons and they denied his request. He's pretty much given up hope. I think I'm going to also try to resign, but what can I do if my resignation gets rejected and find myself in this guy's spot? So far it seems like writing senator/congressperson, registering as a conscientious objector, or coming out of the closet are the only ways to get out, if you're lucky enough. Any ideas for me????....because I don't think I could handle effectively 8 years in a clinic, in the military, with the hassels described in so many other posts, doing a job I hate.
Thanks for the help,
rb

 

[gravy4thebrain]

Any of those above mentioned reasons would violate your contract obligations (e.g. it is too late to register as a C.O.- you already swore that you are not). You left out "cutting off your trigger finger"... that would be destruction of government property). Perhaps attempt an interservice transfer with better opportunities for research (Army Path, Naval Medical Research Unit).

 

[island doc]

To get back to the question AF HPSP originally posted....I actually made the mistake of joining Army HPSP but haven't gone to OBC, no ADT, or any other training. I've just been in the program for a few months and already I know it's not for me, mainly because I've come to realize clinical medicine is NOT for me. It's not a question of money, just what role I want my education to play in my life. I've realized that I simply love to teach and do research. I don't want to bring anyone the worse news of their lives or tell them that they're time on earth is limited. What time I've had in the clinical setting already seals the deal for me. So what do I do now? I heard of a guy (classmate of a friend at another school) in a similar situation as mine. He tried to resign for many of the same reasons and they denied his request. He's pretty much given up hope. I think I'm going to also try to resign, but what can I do if my resignation gets rejected and find myself in this guy's spot? So far it seems like writing senator/congressperson, registering as a conscientious objector, or coming out of the closet are the only ways to get out, if you're lucky enough. Any ideas for me????....because I don't think I could handle effectively 8 years in a clinic, in the military, with the hassels described in so many other posts, doing a job I hate.
Thanks for the help,
rb

The answer is a plain and simple one. If you have no interest in clinical medicine, but would rather do research and teach, then you are pursuing the wrong type of degree. You need to be in a Ph.D. program.

The military cannot force you to remain in medical school and become a physician against your will. The military cannot prevent you from resigning from medical school if you no longer have an interest in practicing medicine. How could it be beneficial to them to force you to become a physician against your will?

You need to be honest and upfront with them about this and inform them that you have decided to withdraw from medical school. Do not approach it from the angle of trying to get out of HPSP, that will not work. Approach it from the angle of having determined that you no longer wish to become a physician and are withdrawing from medical school.

If no funds have been expended then you will undoubtedly be successful, if they have been, they will probably want their money back, or you may be able to work out a deal with the US Government to work at NIH/USUHS as payback.

One more very important point: you need the assistance of an attorney as you go through this process. A health care attorney will be of more help to you right now than anyone else. Consult one first.

 

[rbear]

Regarding quitting school, they could still chase me down for my obligation and have me work it off (although I'm of no use to them)right? As for the acceptance of the stipend and that other financial incentives, I've been doing that for a few months. I just haven't undergone any training with the Army. Would your suggestion also work if I wanted to do MD/PhD on my own or MD/other advanced degree such MPH or JD? I'm quite sure I don't want to leave medical school. I like school, just not the clinical interactions and the responsibility of pt's lives in my hands. I know it sounds crazy. I'm worried about 3-4th years but I think I'll manage esp under 2 layers of authority and control. In addition, I'm already here in med school after jumping through so many hoops, and it seems to be quite a good investment that will open up a lot of doors outside of the clinical realm (conduct clincal trials, consult for businesses, etc.). Point being, I worked too hard and have too much invested to quit school. I'm sticking with the md but am open to staying in school longer.
Thanks a bunch for all of your good posts so far. I really do appreciate as it seems like you guys are about the only source of information I can find for this.
rb

 

[island doc]

Regarding quitting school, they could still chase me down for my obligation and have me work it off (although I'm of no use to them)right? As for the acceptance of the stipend and that other financial incentives, I've been doing that for a few months. I just haven't undergone any training with the Army. Would your suggestion also work if I wanted to do MD/PhD on my own or MD/other advanced degree such MPH or JD? I'm quite sure I don't want to leave medical school. I like school, just not the clinical interactions and the responsibility of pt's lives in my hands. I know it sounds crazy. I'm worried about 3-4th years but I think I'll manage esp under 2 layers of authority and control. In addition, I'm already here in med school after jumping through so many hoops, and it seems to be quite a good investment that will open up a lot of doors outside of the clinical realm (conduct clincal trials, consult for businesses, etc.). Point being, I worked too hard and have too much invested to quit school. I'm sticking with the md but am open to staying in school longer.
Thanks a bunch for all of your good posts so far. I really do appreciate as it seems like you guys are about the only source of information I can find for this.
rb

As long as you become a physician you are destined to become a military clinician, unless your attorney can work something else out for you. HPSP was never designed or intended to accomodate combined degree programs. The purpose of HPSP is to produce practicing clinicians for the military, granted some are also teaching as USUHS clinical faculty and involved in clinical research, but military physicians' primary function is as a clinician.

Once again: Consult an attorney with expertise in the areas of health law and contract law.

 

[rbear]

As long as you become a physician you are destined to become a military clinician, unless your attorney can work something else out for you. HPSP was never designed or intended to accomodate combined degree programs. The purpose of HPSP is to produce practicing clinicians for the military, granted some are also teaching as USUHS clinical faculty and involved in clinical research, but military physicians' primary function is as a clinician.

Once again: Consult an attorney with expertise in the areas of health law and contract law.

Will do, thanks once again. In the meantime, a question: what happens if I never show up for ADTs? Or for OBC for that matter? I realize I'd be in violation of my contract which (according to the contract) would be grounds for dismissal. I've been told these are bad things to do, but no one's ever told me why (jail time?). Can you fill me in?

 

[island doc]

Will do, thanks once again. In the meantime, a question: what happens if I never show up for ADTs? Or for OBC for that matter? I realize I'd be in violation of my contract which (according to the contract) would be grounds for dismissal. I've been told these are bad things to do, but no one's ever told me why (jail time?). Can you fill me in?

If you fail to show, you run the risk of being placed on active duty and prosecuted under the UCMJ, better to employ your own attorney and go about it legally.

 

[gravy4thebrain]

Hmmm, sometimes when a servicemember does not return to active duty, the service will send chasers to your house on Turkey Day. They will arrest you in front of your friends and family. Or you could hide out on every major holiday.
I forgot to mention smoking pot. The military hates pot-heads. They definitely won't want you after a positive urinanalysis (probable other than honorable discharge).