Ask the Half M. D.: but seriously, what’s the catch?

March 4, 2009 at 10:31 am (Military medicine)

I just don’t get it. About once a month I post a rant about how bad military medicine is, point to other resources about life in the military, and link to stories by other physicians about how they’ve been cheated, wronged, or just plain screwed by the armed forces. I even posted a pretty graph to show the loss of income by taking the scholarship. And yet I still continue to get questions along the lines of “Are you serious? Really, it can’t be that bad. What are the advantages?” Here is the latest email I have received from a reader who poses several questions:

1) I am slightly confused about residency in the military. I heard that its TYPICALLY (for usuhs/hsp) 4 yrs med school, 1 yr internship, 2 yrs GMO, n years residency. In other words, despite 75% matching, i heard that the 25% that fell short still do eventually get a residency (i.e. at least fam med/int med/etc.) Albeit, i think this ends up extending ur service years since GMO yrs dont count toward satisfying reqts.

A GMO tour does indeed count towards your payback. If you take the four-year scholarship and do a two-year stint as a flight surgeon, you would only need two more years of active duty service. However, once you start a residency, your commitment will increase. Attending residency is entirely your choice. So yes, most of the people who did not match will eventually end up in residency, although they might wait until their commitment is up so that they can pursue civilian training.

2) how dangerous is being a military physician? What the most danger that theyre in (same danger as combat soldiers vs. supply line soldiers vs. etc)? (i assume the least danger would be at a well established command area)

You’re in the military. You will be deployed. You will face danger on these deployments. Military physicians are listed as noncombatants under the Geneva Convention. However, I am unaware of any nation—including our own—that actually follows the Geneva Convention. Doctors have died in combat in the past, although it is a rare event. Usually, they stay on base at the hospital and don’t travel out with the soldiers on combat missions.

3) Also, do u think that usuhs/hsp prevents u from living at LEAST the stereotypical middle class life (2 toyotas/house/2 kids/retirment/bla bla)?

I have no idea what you’re talking about. Do you mean that taking the scholarship will allow you to live a middle-class lifestyle as a student? USUHS students make above $40,000 a year. HPSP students make around $25,000 a year. Military residents start at $65,000 a year and go up from there. Flight surgeons make about $95,000 a year and up, while board-certified attendings in other specialties start at $120,000-$140,000, depending on specialty. I’m not sure if I’m able to answer your question, but that’s the money that you can expect.

It would be a great help to hear ur input, as opposed to hearing recruiters only. Also, if this isnt too private, why did u decide to do the hsp when it seems like u really are against it? Im just trying to get all the facts before deciding to apply to the usuhs/hsp. Thanks.

Unfortunately, I did not have all the facts when I took the scholarship, which would explain why I’m so against it today. I really think you should… forget it. Just take the scholarship because you obviously don’t care to listen to what I or anyone else has to say about it. Keep my email address handy so that you can let me know how things work out for you during January of your senior year of medical school.

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6 Comments

  1. alexr said,

    Another thing to consider is that (from what I gathered looking at the payscales of military physicians) neurosurgeons and others who have residencies >2x as long as general practicioners only make about $20,000/year more. To this is completely unjustifiable and a big reason why I chose not to do HPSP.

  2. james at poorMD.com said,

    I came a signature away for signing up with the air force. Fortunately, my wife and other friends convinced me not too. Now that I’m a resident in the specialty of my choice, my heart goes out to all my buddies who were forced to be flight surgeons or glorified family practitioners because the military did not need more surgeons, radiologists, or anesthesiologists that year. At least they get to travel and see new places right? Like being stationed in South Dakota or deployed to the Middle East! Sounds like great fun.

    Unless you come from a military background, and want to practice military medicine, don’t do it!

  3. JG said,

    Just as a point of clarification, the compensation for USUHS students and miltary residencies is higher than stated in this article. I’m a USUHS student, and as an O-1 I will make $58,000 this year. Remember, also, that half of that is tax-free, which means my take home pay of $4300 per month is equivalent to a civilian salary of $70,000 per year. As an O-3 during residency I will make $75,000, which is the same as $90,000 after adjusting for taxes. After residency, as an O-3 in internal medicine, I will start at $125,000 ($140,00 after the tax break) and after three years I will be an O-4 making $143,000 ($161,000 after the tax break). Basically, if you’re interested in family practice, pediatrics, or general internal medicine, then going with the military can be quite a deal. On the other hand, if you want to be a surgeon, then just realize that you will be giving up a lot of pay. This is what I have told my friends who are considering the military to pay for medical school.

    As a side note, I just bought a house using my VA loan benefit – 0% down with a low, government-subsidized interest rate. So in response to the reader’s question regarding living a middle class lifestyle: yes, having a steady income during your medical school years can be quite a perk – especially if you’re investment-minded or have a family to take care of.

    Half M.D.: Thanks for the response. My numbers for the salary were based upon when I applied for medical school. I wasn’t aware that the amount had jumped so much.

  4. Ellie said,

    i know you published this awhile ago, but i just found it today. thanks for saying what i was afraid to say for a long time! i wish i’d never signed up! people made me feel as if there was no other option because they kept saying the debt would be overwhelming when i would graduate. now i wish that were my only problem. i’m going through the match process now, applying for a deferral, but not that confident that i’ll get it. and trying to couples match as well. i tell people not to do it, but i still see them sign up because they’re so scared of the debt.

  5. Erika said,

    So from what I am hearing about the military residency programs, it is better that I stay civilian. The main thing I have been concerned about is the cost of medical school and the student loans and such. My question is, is it honestly worth being $200,000 in debt and having to pay back the loans over a period of time rather than having the military pay for it in exchange for your service?

  6. USUHS/HPSP Applicant said,

    Remarkably and unfortunately, this site and forums/blogs like it have some of the best information for medical school applicants looking into military medicine. The problem is that 50% of the points made here are true and 50% are false which makes 100% of it MISINFORMATION if not read in the proper context. I advise everyone looking into military medicine to start from the source: USUHS or the HPSP recruitment webiste. There is a ton of ACCURATE and UP-TO-DATE information at http://www.usuhs.edu/military.html, particularly the “What You Need to Know” pdf file under the prospective students section. The bottomline is… If you’re not thrilled to serve those who serve our country, then neither USUHS or the HPSP is for you. If this does sound like a worthy career/life for you, the benefits FAR outweigh the drawbacks. For one example, there is about a $500,000 difference through medical school and residency (~8 years) between civilian med school and USUHS factoring in only tuition, salary, and taxes. TALK TO A REAL PERSON IN MILITARY MEDICINE! Not someone bitching on a blogsite.

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