If so, which branch of the service did you select and why?
Do you know of any sources of what life is like after you’re commissioned and working in these three branches?
I’m considering doing this, but would like to get some more information so I can better judge which branch of the service to do this through.
my father was a military doc for 20 years, and my sister is doing the Army HPSP thing right not (she’s an MS-2 at the moment).
There are lots of pros and cons to the scholarship. I was in the Navy for 7 years, and I have come to the decision NOT to go the Navy route, but that is my decision. It can be a very good deal.
I recommend going to student doctor network, and check out the military medicine forum. There have been tons of threads there that can answer many of your questions.
I would say: 1. DON’T do it just for the money. 2. DON’T take at face value ANYTHING a recuriter tells you. Check with people here, SDN, current docs - and get in writing - anything before you believe what a recruiter says. Go into it with your eyes open, and if that’s what you decide to do, have a great time serving our country.
Oh - and you might want to check out the websites for each program. They have all the basics.
Good luck,
Matt
>I was in the Navy for 7 years, and I have come to the
>decision NOT to go the Navy route, but that is my decision.
Mind if I’m nosey and ask why?
A few reasons:
1. Military medicine is becoming more ‘expeditionary’. This, coupled with the very high op-tempo (read: lots of people stationed overseas) means I would very likely be ‘over there’ quite a bit. I’ve done that when i was younger, don’t need that merit badge. If that is something you WANT to do, this can be a plus.
2. The money is nice, but I think in the LONG run (10-15 years), it comes out as a wash. You make lots more in the military during med school and residency, then quite a bit less in practice. If I had a family, or needed money during school (1200 bucks a month to pay rent is nice), the scholarship is pretty good.
3. I’ve heard some strange rumors about military medicine and specialities. Like board certified surgeons being sent out to sea as ship’s doctor on an aircraft carrier, and losing their skills.
4. So many military doctor’s leave after a few years that there is a vacuum of leadership at the high officer (Colonel, Captain) ranks. This leads to a loss of mentorship of young doctors and people to ‘look after you’. The military has compensated by opening up the leadership roles to nurses as well. Nothing against nurses, but I think it is leads to some bad situations where the ‘operational’ situation (medical care) has the doctor in charge, but the ‘administrative’ situation has the nurse in charge. There have been some documented problems with this (I think Walter Reed and the anesthesiology department).
5. Military medicine is farming out quite a bit to the civilian sector. So many specialties are being phased out. I think C-T/cardilogy is one example. So there are no more residency programs in these areas. Not that I want to be a CT surgeon, but it’s important to me to have that choice in a few years.
6. At least in the Navy, they are talking about ‘downsizing’ the active duty medical component by 50% over the next five years. The will fill many/most of the stateside hospitals and clinics with ‘contract’ civilian doctor’s and nurses. So . . . . where do active duty types go: more overseas time.
7. I know that if I change my mind, and get in a bind, there is a program called ‘FAP’ that acts like HPSP after the fact. I.e. if you decide to go military AFTER med school, they will repay loans. So, I know I have the choice down the line.
Sorry for the rant - this is something that I have actually done quite a bit of thinking about. Hope it helps. 
Matt
There is little difference between any of the services in regard to physicians. The Air Force may seem like the better choice but the problems there are not enough residency slots for all the physicians…extreme competitiveness. To make yourself a better candidate you volunteer for the assignments no one else wants…it’s the same thing in all the services.
The biggest thing to remember is that you are a soldier, sailor, airmen…FIRST and a physician second. For those of us who’ve already served this isn’t anything new. However, if you have never served this warrior first mentality will be a huge problem. Especially when you finish a surgical residency and are sent to an aircraft carrier where you might get to do 15 appendictomies a year…and aren’t allowed to scrub in the local military OR because of the ship’s hospital administrator outranking you but with no common sense.
The Army is sending full fledged physicians to the front lines so don’t fall for the recruiter line that as a physician you will be “in the rear with the gear.” As units forward deploy=(close to the enemy) so will you. You aren’t immune from this in the Navy nor the Air Force. The Navy has the Marine’s to support and the AirForce…well it ain’t easy but it’s easier with the flyboys.
Again, the biggest issue in the AirForce is you have to be very flexible in your residency choice. There have been many physicians I’ve spoken to who did not get into what they wanted. Not saying you can’t but the chances are dependent on some factors which you may or may not want to play with. Politics plays a huge part and difficult assignments do not guarantee a residency slot.
I hope to either get a scholarship or even better get accepted to USUHS. However I’ve been in military medicine since I was 18, now 14 years. The last 4 years I’ve been a civilian at my last duty station and it’s the same environment. My choice is Navy. The op tempo is ever increasing but if I want EMED, surgery or ortho then that’s the price you pay. Like in everything there are loopholes but it’s best to go with what you know. I know the Navy. I also know that as a physician I will not be able to provide the best care for my Sailors and Marine’s. It’s a fact of military life but I can’t change it from the outside.
All in all I would do what you’re doing and continue to ask questions. Be careful with the “get it in writing” mentality. The other thing that’s in writing is “needs of the service” which supercedes anything guaranteed by the contract. They can promise you the world and put it in writing but in the end the needs of your particular service supercede everything.
Like it’s been said:
1. Don’t do it for the money. If you don’t have prior service which would help toward retirement it just doesn’t add up.
2. Prepare yourself to be under the authority of a nurse or health care administrator. It becomes a problem when the lines are blurred in regard to patient care and your military responsibilities.
ON THE FLIP SIDE! 
Where else can you have the oppurtunity to:
jump out of aircraft
scuba
serve onboard subs
aircraft carriers
fly fighter planes
save lives literally under fire
work in research (transplant, stem cell, vaccine development, biowarfare, blood substitutes, cryonetics, diving…)
There is the good, the bad and the ugly in the military. The outlook is dismal but that depends on your attitude and what you will do with what you have. Many choose to jump ship. Many choose to stay and just deal with it without changing anything. (Not easy to make changes because of the chain of command) Few choose to stay and make changes because it’s equivalent to banging your head against the door till someone opens…only to find it was the wrong door…once you find the correct door the policy has changed and you have to look for the other door.
I’m sorry if I’m giving the military a bad rap but you have to make this decision with both eyes and ears wide open. Get some thick skin and kiss the wife and kids goodbye for months at a time. Fact of life serving in the military. It ain’t the easy life it once was and it’s getting worse for the specialties they plan on keeping. The ones getting chopped are pediatricians, OB/GYN, certain surgical specialties, IM specialties are taking a hit as well.
Basically if you can’t do something to the war fighter to get them back in the war quickly your worth to the military decreases almost exponentially.
If none of this is appealing yet you would still like to get the stipend and wear a uniform there’s always the public health. As long as your okay with family practise or IM then you’d be fine. The “serve in underrepresented areas” bit is a little gray. Meaning to say that centers such as the NIH are underrepresented. Basically the commissioned corps of the public health is underrepresented and you can go active with them and get all the same benefits with less of the blood, sweat, & tears of the active military. Maybe it might be an option for you.
I appreciate all of your feedback. I’ve been considering my future as a doctor quite a bit and basically have come down to two potential paths for me to follow:
(1) Stay civilian, do the student loan thing, go Emergency Medicine, and work in a semi-rural ER near my home.
(2) Go navy, attempt to get a residency in Aerospace Medicine and become a flight surgeon and eventually see if I can get involved over at NASA either as a crew surgeon or a mission specialist. I’m coming to this career as an ATP rated civilian pilot with 6000+ flight hours so I have to admit the second option which would involve patient care of pilots and/or astronauts, and even the potential of manned space flight if I hit the lottery, is very appealing.
On the other hand, with the Navy considering a 50% RIF in the doctor ranks #2 may end up being a pipe dream where I get stuck as a GMO to serve out my 4 year committment after medical school and then am that much older and less competitive for civilian residencies.
You know, if I have to keep making decisions like this, I think I’m going to invest in a magic 8 ball. 
Boeing, of all the branches it seems the Navy is most likely to put you into a GMO slot after your intern year - and then following completion of a GMO tour of a few years you get to go back and finish your residency. I don’t know enough about how it works to comment on the pros and cons of that arrangement, I just know I’ve heard it discussed lots. The other branches seem more likely to let you finish out residency before doing your active duty service.
Mary
Hi Boeing,
I started a thread on this subject (it had “navy” in the title) a few months ago. I got very helpful feedback from OPMers who had been in the military and knew what things to consider, so you might want to search for it.
I met with a Navy rep last summer who told me that you can do your residency anywhere–it doesn’t have to be at a Navy hospital. So you could go into any specialty you could match into, I guess. Regardless of where you do residency, you still have to pay the Navy back for every year of support they’ve given you, and that starts AFTER your residency ends.
The main reason I was interested in the scholarship was the financial assistance during med school, plus the opportunities to do underwater or aerospace medicine, just like you mentioned. I would love to get in with the astronaut corps too! However I have some other interests to consider as well, and then there’s the fact that they don’t allow women on subs. No Das Boot for me… Plus the commitment is more or less 15 years–a very long one.
I can’t offer much help but you might want to look up that thread. I think Tec on this board is on an Air Force scholarship too.
Pushkin,
Thanks for remembering me I had my Neurology clerkship final this week, so I waited until this weekend to respond.
Here is a link to someone’s questions earlier this year: HPSP question
Since I wrote those, I’ve come to see more pluses and minuses to the scholarship. I’m pretty certain that I will go into either Neurology or Internal Medicine. If I were not committed to the military, then I would have the option to apply to the 12 combined neuro/IM residency programs. That said, there are many days where I realize how much I miss being in the military environment where you have a great sense of mission and committment to a team. My neurology clerkship director and I were talking Friday and he spoke about how “dog-eat-dog” and “individual centered” academic medicine is. My three years in civilian schools have opened my eyes to the “real world,” making me more appreciative of the teamwork in the military. Don’t get me wrong, the military has its faults, but I’m looking forward to going back to those faults.
I know somethings about the Army scholarship, which in many ways is similar administratively to the Navy scholarship. I helped found a military medicine group at my school so we didn’t have to keep reinventing the wheel with the administration, so I can ask the people on Navy scholarships too. Please don’t hesitate to ask any question (no question is a dumb question).
The miltary is a great way to serve, but it is not for everyone. If spending time away from your spouse or child is a thought you can’t even think about then the military is not for you. If you are trying to be a world-famous surgeon, then the military may not be the best way to get there. If you are adventurous, want to treat some of the greatest people in America, and want more out of medicine than your standard practice, then the military is something to give some thought to.
Hope this helps,
Tara
I forgot to talk about the GMO thing. The Army and the Air Force have pretty much gotten rid of GMOs. The Air Force is even limiting people who are flight docs as GMOs. They have realized that you are much more valuable to them as a board certified physician than as a GMO. However, the Navy still uses them. I have virtually no worry about becoming a GMO.
As for hospital administration, we received a talk from an Army doc last week and he explained that the lessons learned from OIF have shown them that physicians need to command the hospital. He said that the Army is going to go back to having physicians command hospitals. Also, when I was looking into the scholarships back in 2002, I met with the Chief of Staff, a physician, of Malcom Grow on Andrews AFB. So it’s not as if physicians are left out of the decision making process. The move was originally made to having non-physicians command as to allow physicians, who were in shortage, to spend more time practicing. So the jury is probably out in light of recent deployments.
While treating the warfighter is a large part of your mission, if you work in a hospital, then you are also treating the members of the military families. There are places for specialists to practice in military hospitals. However, the military monitors how many physicians of each specialty they have on the books to make sure they have the right allotments.
I have accepted the fact that I will be underpaid as compared to my peers. But since I come from a family that didn’t have that much while I was growing up, my pay when I got out in 2000 as a captain (which was less than I will get as a doc) was more than enough, so anything over that is bonus. I didn’t go into medicine to get rich, so I don’t feel that I am giving up a lot in that sense. Plus in the military I will have opportunities to experience things that I would never get the chance to on the outside (be a flight doc, live overseas, go on humanitarian missions, deploy…etc).
Tara
Just as a side note…let’s be careful dishing out the “50%” as if it were gospel. For one thing I work at a Navy command and the 50% includes the medical service corps not only the medical corps.
Yes, in regard to the GMO tour the Navy still has it and will always have it. There’s no getting around it. Many think it is silly to send, what amounts to a second year intern into the fleet to be the medical officer, however how much sillier is it to send an attending. The Navy GMO tours get a bad rap however with the “it’s a marathon not a race” mentality we have here who cares how long it takes. The reason I say you should only do this if you want to serve as a lifer is just because of that reason. A small breakdown:
4 years medical school
1-2 year intern
2-3 year GMO (counts toward payback)
3-6 year residency (does NOT count toward payback)
2-3 year GMO tour
At the short end you’re looking at 8 years. On the long end about 14 years. Someone with prior service would have enough time to retire within this span of time. However many would not and must take things into consideration. While I’ve said not to do it for the money the reality is if you have a family the military isn’t a bad option on the front end. The problem is I’ve seen, served and spoken to many (~30+) HPSP’ers who did it for the the front end money only to be the most miserable physicians on the face of the earth. In their defense…hehehe get it…defense…never mind…these same physicians were traditional and without question thought they had been sold a bill of faulty goods.
If aerospace medicine is your thing then look into it thoroughly. Find a few physicians doing what you want to do and ask as many questions as you can. How they got to where they are? How you can do the same? Should you? Why? Why not? If they had to do it over again what would they do different? Deployment schedule? Family accommodations? Do they travel to seminars and present?
Just keep chipping away. I don’t think your dream of working with the spacey flyers would be a problem. However I don’t know for sure. I do know that the ones who come into the Navy to experience as much as the Navy has to offer have a great time. I did my time as an enlisted man and had some fun. Sure there were times that outright sucked. As an example as a young 20 year old I was married on July 14 and on July 28 I was on the island of Okinawa as a geographical bachelor…? The reason…well the admin poges at PSD “forgot” to tell me that if I wanted my wife to come with that I would have to modify my orders. At the time, all I was told was the marriage license was enough proof of a modification request. My fault. Lesson learned…do NOT take anything as gospel in the military. You have to become an expert in everything so that you can look out for you and yours (family, troops…) With your path in aerospace med just learn to be flexible. Sometimes that flexibility will hurt and hurt bad but in the end things work out. The military is still respected by many civilian employers and even though that is years away thinking about life on the outside should still be in the forefront once you make it in.
If you’d like I can ask around and see if I can stir up a aerospace guy? I don’t know of any personally but a friend of a friend of a stranger of another stranger works with a second cousin who might know of one
Quote:
If you’d like I can ask around and see if I can stir up a aerospace guy? I don’t know of any personally but a friend of a friend of a stranger of another stranger works with a second cousin who might know of one
Thanks, that would be great! The other option that I’ve discovered today is a program through the state army guard. They don’t pay for your med school up front, but there is some money involved in the weekend a month + two weeks a year business. Also you have the added advantage of your 20 year clock starting right away instead of after you graduate - meaning that by the time I’m done with residency I’m almost halfway to a military retirement. Finally, there is a good chunk of loan repayment money + retention + bonus money available.
No GMO tour and I could go straight into a civilian residency upon graduation. I’m curious how guard deployment would affect my civilian practice as an ER doc though.
Just be a little careful with the Guard. It isn’t the skate job they advertise. I have friends who went Guard and they are over in Iraq. Not physicians but they have their physicians with them. The thing with the retirement in the Guard is “yes” you get a retirement however it doesn’t kick in until 59 which would be the earliest you can begin to receive it. The retirement is dependent on how many points you accumulate during the years of service. It’s not a bad deal but it will definitely be a part of life for you if the retirement is what you’re interested in.
Between Guard, Reserves or Active Duty I would choose active duty. To me it makes no sense playing army. I did reserves for 2 years and it was worse than the 10 years of active duty I served. I enjoyed my time active but the reserves was full of wannabes or life long reservist who had nothing short of contempt for prior active duty. This wasn’t everyone but definitely the majority.
Don’t let the GMO tours scare you. Too many people give it bad rap. The docs I’ve talked to are typical military people in their thinking. In that, “your current duty station is the worst, the previous one was the best and the next one is going to be awesome” There’s more to GMO tours than just slave labor or whatever other nonsense many spew about GMO tours. In the Navy you can go to dive school and become a DMO for your GMO tour. These are non-traditional assignments and allow you the chance to work with some great sailors and Marines. You may luck out and get to serve with the SEALs. Check with a DMO on deployment schedules and you’ll see what I’m talking about. There are also the GMO’s with the Marines. Go on a couple of 6 months of deployments and the rest of the time is spent at the BAS preparing for residency. Now I’m not a physician…yet…but I worked with plenty when I was with the Marines and they complained all the way to the golf course. 
They worked…ahem…hard and definitely played hard.
I guess in the end what I’m saying is that GMO tours aren’t the end of the world. It gives you a chance to experience what the military is all about. If you want to do high speed stuff it’s there. Naturally there is the sickcalls and what not but in the end the life of a doc with the Marines isn’t that bad. Train your corpsman, get a good IDC and your golden. They will ask you to stay out of the way and only call you in for the unusual, emergent or just plain funny. The more you are “one of the guys” willing to get down and dirty the more you will be respected and the less “Doc…can you see this guy?” you will get.
Trust me. The docs who only wanted to “do their time and get back to real medicine…” were also the ones who rarely had time. We had those elitist taking care of runny noses, sprains, strains, rashes, STD’s…you name it they took care of it. How is that possible? Well…if it took us “glorified orderlies” 45-60 minutes to diagnose a cold or merely take the history and observations of the SOAP note…it made for a loooooong day. This physician was a naval academy grad who’s fecal matter didn’t stink…
We had a Harvard grad who would stay home because in his first few months he had proved he would be there for us and get down and dirty. So much so we had to ask him not to because it gave the perception we couldn’t handle things. After a time our IDC told him to stay home or within reach of a phone and we would call him with anything. He studied ortho and relaxed…
I guess I’ve said all this to let you know that GMO tours aren’t as bad as you’d think. Next time you hear a Navy doc complain about how bad things were for them and how incompetent the corpsman were…well…just and think that perhaps they were the problem. Show up to work hard and train your guys as much as possible and you’ll be fine. Show up with the “I’m a doctor and an officer and I don’t want to see x,y, or z…” Watch out because you just ensured you will have the worst GMO tour this side of the Mississippi.
I’ll get to work tracking down an aero guy for ya. 
crooz,
Well said!! That philosphy holds true for all enlisted-officer relationships in every branch. It’s nice to know that somethings will be like I remember them
Tara