USUHS (Navy) vs. Jefferson (HPSP) - must decide by today/Thursday

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inhcas

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So I have to decide by today...I've been giving this a lot of thought and talking to people over the past two days, since finding out, but I decided to consult you guys as well.

My dilemma is a lot like this thread: Reasons for HPSP vs USU?
OP ended up taking a full-ride elsewhere, so that's how that one ended!

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I'll be 30 this summer. Female. No family, don't really like kids, but not closed to it. I'll be 44 by the end of the USUHS obligation, 41 by the end of Jeff HPSP.

I'm someone who's fine with being part of the military. I've never served or have family who has, but I attended USMC OCS before, so I have an interest in it. And I think my goals align well with such a life (see bottom). I'm not **100%** sure about the military, but I think that's just because one is never truly sure about anything; I'd say I'm sure enough. I adapt well to circumstances anyway and can find things anywhere to make life more enjoyable. I'm interested in EM (a generalist specialty), though that can change.

So since both of my choices include me spending a stint in the military, the differences between the two are:

USUHS
- 7-year commitment after residency
- paid ~$60K/year during school
- I would have already spent 4 years becoming part of the military culture, so I'd feel more a part of it
- live in DMV (I prefer Philly because it's smaller and better for biking, but I've been to DC a lot and it's fine)
- can network with instructors, who have connections to all sorts of things in the military
- have to drive to climbing gym (~30 minutes) - this is more inconvenient

Jeff
- 4-year commitment after residency
- paid ~$25K/year during school
- live in Philly
- I still think their students were the warmest, most loving group I met among the schools I interviewed at, though I could see myself among USUHS students as well
- can bike to climbing gym (~15 minutes)

There are things that would be the same whether I do USUHS or HPSP, so I list them at the end if you care to read. But one thing that I really want to prioritize and get better at is people/social skills, emotional intelligence, being engaging, and earning strangers' trust, which is so important for doctors. I think I can improve at this no matter which school I go to, as long as I make a concerted effort?

Something I admire about people in the military, and also many doctors I've met, is their self-confidence and self-assurance. I love that and want to be around those kinds of people. Not everyone who is in the military is like that of course (it's such a big organization, you can't generalize everyone like that), but I feel like I can find people like that. Especially Marines, just based on personal experiences; I admire every single one I've met - they have that aura about them, and that stereotype is pretty true.

Related to developing confidence: In addition to learning to practice medicine, my goal through med school/in life is to develop the personal aspect: personality, emotional and social intelligence, social/people skills. Docs have to be able to connect with strangers and gain their trust immediately in order to help their patients. That's not my strength, but I'm sick of not having better people skills, so I'm determined to seek out opportunities to work on this whether I go to Jefferson or USUHS, or any other school.

Other stuff that would be the same whether I do USUHS or HPSP
Career goals:
To have a varied career, including: clinical practice (military and civilian), deploying to combat zones, working with astronauts/people traveling to extreme environments, working at research stations in Antarctica or other cold/remote places or at Everest base camp, doing consultant-type work (changing projects every few months, or minutes as in my current specialty interest of EM, seems to fit my personality), working with MSF or similar organizations, working with athletes, or doing something related to technology/innovation/entrepreneurship.

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A lot of this depends on your career goals. Your stated goals are to work in extreme environments, deployments, etc. Do you want the 20 year military career?

USUHS will give you the leg up for that. Your 20 year minimum starts when you graduate, but in USUHS the time in school counts past that twenty years. So you'll get the 24 year pay for retirement vs the 20, after 20 of service.

USUHS may also give you the leg up in residency and be a better deal. EM is one of the more competitive residencies in the military (more so than in the civilian match). USUHS may be more competitive (I cant remember 100%, so take with a grain of salt). More importantly you are likely to do GMO tours (EG. Battalion Surgeon, Flight Surgeon, Undersea Medical Officer) before residency (time in service = more competitiveness with the match). You can actually serve our your HPSP obligation without being a board certified physician, and then go enter the match as a civilian.

When in residency, you pay a year off and incur a year of service at the same time. If you enter residency directly it doesn't really effect your obligation, but if you enter after say a 3 year GMO tour...

HPSP: 3 years GMO payback +3 years residency = you owe 2 more years, for a total of 8 years
USUHS: 3 years + 3 Years Residency = 4 more years, for a total of 10 years.


With residency this gap can close. Also, aerospace medicine residency is an option in the military that isn't really available in the civilian world. It is essentially medicine in extreme environments.
 
A lot of this depends on your career goals. Your stated goals are to work in extreme environments, deployments, etc. Do you want the 20 year military career?

USUHS will give you the leg up for that. Your 20 year minimum starts when you graduate, but in USUHS the time in school counts past that twenty years. So you'll get the 24 year pay for retirement vs the 20, after 20 of service.

USUHS may also give you the leg up in residency and be a better deal. EM is one of the more competitive residencies in the military (more so than in the civilian match). USUHS may be more competitive (I cant remember 100%, so take with a grain of salt). More importantly you are likely to do GMO tours (EG. Battalion Surgeon, Flight Surgeon, Undersea Medical Officer) before residency (time in service = more competitiveness with the match). You can actually serve our your HPSP obligation without being a board certified physician, and then go enter the match as a civilian.

When in residency, you pay a year off and incur a year of service at the same time. If you enter residency directly it doesn't really effect your obligation, but if you enter after say a 3 year GMO tour...

HPSP: 3 years GMO payback +3 years residency = you owe 2 more years, for a total of 8 years
USUHS: 3 years + 3 Years Residency = 4 more years, for a total of 10 years.


With residency this gap can close. Also, aerospace medicine residency is an option in the military that isn't really available in the civilian world. It is essentially medicine in extreme environments.
I'm not sure I want the 20-year career. 20 years seems like a long time to me; it's hard to tell right now.

I think you maybe meant to write "HPSP: 3 years GMO payback +3 years residency = you owe 1 more year, for a total of 7 years"?

Yup, I'm interested in aerospace or wilderness medicine.

Again, it's hard to say where I want my career to go. I've been reading the threads over in military med, and the opinions are more negative than positive. I really want the experience of being in the military and practicing military medicine. But I'm also aware of all the cons people have described - though a lot of the posts are from the 2000s.

Related to that, I don't have any prospects of having a family anytime soon, but I never know. I also know one's outlook on life depends on personal attitude. Just gotta make sure to take care of mine (may be easier said than done depending on the circumstances...).
 
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I'm not sure I want the 20-year career. 20 years seems like a long time to me; it's hard to tell right now.

I think you maybe meant to write "HPSP: 3 years GMO payback +3 years residency = you owe 1 more year, for a total of 7 years"?

Yup, I'm interested in aerospace or wilderness medicine.

Again, it's hard to say where I want my career to go. I've been reading the threads over in military med, and the opinions are more negative than positive. I really want the experience of being in the military and practicing military medicine. But I'm also aware of all the cons people have described - though a lot of the posts are from the 2000s.

Related to that, I don't have any prospects of having a family anytime soon, but I never know. I also know one's outlook on life depends on personal attitude. Just gotta make sure to take care of mine (may be easier said than done depending on the circumstances...).

Not quite. For every year in residency, you pay one year off but accrue another. If you don't have any debt you will just accrue (to my knowledge), and you are obligated to serve at least one tour after residency.

So HPSP: 4 years debt - 3 years GMO =1 year left
Residency pays off that one year, but you accrue three years from EM or Aerospace while in residency. Now you have 6 years total in the military at this point (3 years GMO, 3 years military). You owe a tour as an attending now for the 2 years you still need to pay back from your residency. So I think that's 8 years total.
 
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