Financial analysis of the Health Professions Scholarship Program
Each year, military recruiters descend upon medical schools and pre-med fairs with the intention of signing people up for either the Army, Navy, or Air Force. Their goal is to fill the military with physicians to care for the soldiers in battle. They will cite patriotism and throw out stories of hero doctors and tell you than you (yes YOU) can be a Hero, MD. The greatest incentive they have is the Health Professions Scholarship Program. HPSP will pay for all of your tuition, fees, books, and supplies. All you have to do in return is serve a commitment of one year in the military for each year you take the scholarship.
The Student Doctor Network has a forum dedicated to military medicine. Many current and former active duty physicians will attempt to dissuade candidates from joining using a variety of illustrative stories to show that the mil med is overly bureaucratic, promotes ineffective leaders, and punishers free thinkers and whistle blowers. Think Walter Reed, but on a nation-wide scale. While the posters of SDN have their own reasons for their dissatisfaction with the Defense Department, my goal is to provide a quick and dirty financial comparison of HPSP to the civilian route. In other words, is the scholarship worth it?
First, let’s see how much the military is paying. I’ll use my school as an example.
Tuition = $30,000
Health Insurance = $2,500
Books = $1,500
Supplies = $700
Laptop rental = $200
Rounding up, the military is paying about $35,000 directly for my schooling. I also get $17,000 a year for a stipend. Over the course of four years, the military will have paid $208,000 for me to go to medical school. Now let’s do a comparison of different specialties and see how they stack up to HPSP. For salaries of military doctors, I used the Navy’s Pay Calculator. For the salaries of civilian residents, I took a rough average of several hospitals’ pay tables for post-graduate medical education. For the salaries of civilian doctors, I used the information provided by Washington University’s Residency Web.
Let’s start with internal medicine. I’m going to make a few big assumptions:
- No deployments
- I used my zip code (a rather expensive area to live) for the Pay Calculator
- No inflation or changes in salary for either civilian doctors or military personnel.
- No interest rates on student loans.
- The military doctor has no prior experience and gets promoted to major after six years in service.
For the civilian doctor, let’s use a similar table. Since I’m going to account for the $208,000 in debt that this person has, I’ve added another column, Wealth after debt.
From these tables we see that at the 7 year mark—the point at which the HPSP commitment is over—the military doctor comes out ahead. In fact, even after the ten year mark the military physician has accumulated more wealth.
Now let’s run the same course for a general surgeon:
After just three years in practice, the civilian route wins. If these two surgeons practice medicine for the same amount of time, the military doctor will never catch up.
Now let’s consider a radiologist:
Here, the civilian route wins out after just 2 years of practice.
Conclusions: the Health Professions Scholarship Program is not a good financial motivator for luring people into the military. Only primary care physicians will see a financial benefit for joining the program. While my assumptions place limitations on the overall accuracy of my calculations, I stand by my initial statement. Worth noting, however, is that the military has no malpractice insurance and that there are lots of benefits such as free healthcare, cheap shopping and entertainment on base, and a tax break of almost $10,000. Also, the federal government has authorized the military to raise the HPSP stipend from $17,000 to $30,000 a year—although no appropriations have been made. In some urban areas, military students are forced to take out loans to make up for the paltry stipend that we graduate students are receiving. By raising the stipend, students will be able to live comfortably without resorting to more loans—something HPSP was supposed to do away with.
Half MD.com 
Howie said,
May 19, 2007 at 11:13 pm
Wow, this is a great article. It’s useful, witty, and insightful.
I’m a premed-head but I was also in the military for six years (as a medic). A lot of the doctors I worked for were idiots–but there were some that motivated me into becoming a doctor in the first place.
Because of this blog entry, I’m definitely going to consider HPSP only as a last resort (if I even get the luxury of choosing).
Bravo Zulu.
halfmd said,
May 19, 2007 at 11:28 pm
It was a bad move on my part. I knew that I would make less, but I was sold on the idea that the money would be offset by better lifestyle such as less paperwork, no admin hassles, and easy hours. Boy was I surprised that the opposite was true. And to top it all off, I may not even get into the residency that I want.
Nope said,
July 6, 2007 at 11:53 am
While I commend you for taking hard look at the economics of the program, I’m afraid this is not a realistic way to look at the HPSP. In fact, there is absolutely no way to end up ahead by taking the scholarship.
The crux of the problem lies in that you won’t pay off the loan in five years. Your analysis assumes that you devote your entire annual salary to repaying the loan. Student loans do not work like that, nor should they. Student loan rates are amongst the lowest in the country; one would want to pay them off as SLOWLY as possible because money deposited elsewhere would grow at a HIGHER rate. This concept is known as leverage: buying higher rates of return with money borrowed at low rates, and is practiced by almost every financial institution and high-net worth individual on the planet.
In truth, at prevailing rates, a student loan payment is only $1,280 a month. This sounds like a lot when you’re a student, but keep in mind that upon successful completion of a residency, you’ll probably step into job paying between around $12,500 a month to…who knows as a surgeon in a coveted field? Also keep in mind that student loan interest is deductible: without getting too much into the math, you’ll be paying the equivalent of around $800 a month in after-tax dollars. That equates to a maximum of 6.5% of your monthly income. Less than you’d spend on gas in a month.
Do your homework! If you wanted to learn more, I would suggest looking up the following:
– time value of money
– leverage
and – Student Doctor Network!
NavyDO said,
July 14, 2007 at 3:57 pm
It seems as though you have included some of the bonuses such as specialty pay in your calculations, but don’t neglect many of the smaller bonuses and tax benefits such as BAH which can add upwards of $2,000 of tax free income per month. Also, you should consider in your calculations the added benefit in interest reduction you can expect on your loans when the government pays for your medical education up front. Consider if you have $250,000 in debt upon graduation and planned to pay that off over 30 years at the current interest rate of 6.8%. You can expect to pay an additional $336,732 in interest on top of your original debt! Because the HPSP stipend is not enough to cover all costs of living, an HPSP student (like myself) may have around $100,000 in debt upon graduation. Paying this debt off will cost an additional $134,693 in interest over the same time period. Do the math and you’ll find a “hidden” bonus of over $200,000 or more if you decide to pay off your debt sooner. Just some food for thought . . .
AF Doc said,
August 15, 2007 at 12:54 am
As an Air Force Urologist, I concur completely with this assessment. HPSP only makes sense if you want to be a primary care physician. If you want to specialize (especially in a surgical field), you will never catch up with your earnings. Furthermore, depending upon where you are willing to live, many hospitals will pay off your student loans for you when you sign a contract with them. When they’re willing to do this, the benefit of HPSP disappears entirely. Much like the HPSP stipend that has not increased significantly in years, the bonuses that they give physicians have not increased in years, either. I strongly discourage anyone who wants to be a surgeon from taking the HPSP.
halfmd said,
August 21, 2007 at 8:21 pm
What disgusts me more than the money issue is the Air Force’s residency fiasco. Since I want to do emergency medicine, I’m setting myself up for a huge disappointment come Match time. While the military will not release any official statistics on the Match, the current thought is that only 1/3 of applicants to emergency medicine programs matched last year, meaning that the odds are definitely stacked against me. There is a very real chance that I might get stuck doing flight medicine—a field that I am not interested in, nor will it pay well. If I could go back in time, I never would have taken the scholarship. All of my friends are considering externships and various places around the country where they can train. Meanwhile, I’m worried that I’ll end up at a barely accredited program and watch my skills atrophy during my payback years.
jeff said,
December 18, 2007 at 8:31 am
well on the SDN forums, apparently you get so much less clinical experience as a surgeon.
i will be checking out this blog in the future and hope sincerely you dont get posted to flight surgery!
Think said,
February 6, 2008 at 7:28 pm
I understand that the money is less in the military vs. civilian world. So it goes. Don’t join the military for the money. Hands down. For that matter, don’t be a doctor for the money. Hands down. If you decide to be a military doc, do it with the knowledge that you are helping the soldiers of the US Armed Forces. Young folks many of whom came “up from nothing” so to speak, and many of whom have paid a price in our current conflict.
I for one am glad to be a military doc.
AF_Primarycare said,
March 10, 2008 at 11:43 pm
I agree with Think. I have 18 years in USAF. I’ve flown low level in F16,B1b’s,c130’s and Navy P3’s. I’ve deployed to jungles, the Balkans, Europe and the deserts;all of which have been highlights. I have been the only doc and I have save lives when there was no attending/consultant or lawyer (for that matter) around. I can’t tell you how good that feels. One of my physician commanders is in the AOR presently by choice. He told me you can loose a lifetime of memories taken up by rounds and meetings,but deployment memories will last a lifetime.
For those whose life is motivate by money the AF would not be for you, but that is not why I get up in the morning.
Navymedstudent said,
April 3, 2008 at 8:10 pm
Student loans are at 7%. Nope is right, during your residency you don’t use much of any of your money towards loans. You should recalculate using those two assumptions. By the end of a 3 year residency, the loan is $255 k, 5 years is $ 291 k. 20 year monthly payments are $1977 and $2256, respectively. Although, with forebearance penalties due to the end of using the debt:income ratio, those amounts will increase. And that $12,500/month civilian (adjusted for the decrease in medicare reimbursements?) gets taxed down to under $9000. Food for thought anyways.
SpouseofaResident said,
April 25, 2008 at 2:44 pm
Just wanted to clarify what Nope said. When you are an attending and in repayment of student loans, your interest will not be tax deductible (unless you make below about $140,000 a year and married fililng joingly). If you are in a specialized field and clearing more than $200,000 NONE of your interest you pay is tax deductible. If you do qualify, only interest up to $2500 is calculated. More info at http://www.irs.gov.
ENSNavymedstudent said,
May 5, 2008 at 10:20 am
I agree with what a few of the previous military doctors said. When I talk to my friends about my scholarship and the US Navy I make it clear that if they want loan help, or a free tuition, the Navy is probably not for them. It is called national service, it is not a cake walk. I feel that sailors, air men, and soldiers that are in it solely for the financial benefits should not be in the military. Not to get all high and mighty, and I know I am a student with no military experience besides ODS, but, I knew before I signed my contract and received my commission that although the military would support me financially, I wouldn’t be making the enormous sum of money from the private sector.
The military is strained for doctors right now, and does try to entice people with bonuses and cash, but if that is all you are thinking about, I would strongly suggest that you do not accept the scholarship and leave the opportunity available for someone who is more concerned with service than necessarily money.
Cthulhu Dreams said,
May 29, 2008 at 7:54 am
What gets me though is why should people who want to join the military get jacked around. If they are going to pay you less, there needs to be other benefits – like better training (the militaries normal shining star) – but it appears he gets screwed there too. You’re trading less professional fulfillment for patriotism, and frankly modern armies are more professional (mercenary) and less patriots (badly paid volunteers).
Thats not a bad thing, just saying if the operation is to be sustainable long term, you need to offer a complete package.
College said,
June 18, 2008 at 10:02 pm
We are proud to add this scholarship “Health Professions Scholarship Program” to our database of scholarships at http://www.freetoapply.com
student said,
October 22, 2008 at 8:37 pm
The math here is all wrong.
You have to include interest at all levels. You have to account for massive tax differences. You have to include the Navy bonuses. When you account for these 3 items, you will find that HPSP is much more attractive. Unfortunately, medical students don’t understand finance very well.
halfmd said,
October 23, 2008 at 9:39 am
I wrote this piece before the military starting offering the signing bonus. The tax difference is the equivalent of about $10,000 in favor for the military. And given that civilian docs will be making more than $10,000 above their military counterparts, the tax difference doesn’t make that much of an impact. You’ve got me on the interest, but even then, several models have demonstrated that military docs will come out behind unless they pursue primary care.
fizzlemed said,
November 9, 2008 at 8:13 pm
I can’t tell you how thankful I am I read this post.
Joe said,
December 14, 2008 at 1:54 am
Don’t forget the $95,000 or so you get in stipend money during medical school.
Half M.D.: I mentioned the stipend above and used it in my calculations. The stipend has, however, raised considerably since I wrote this article.
Wes said,
January 15, 2009 at 1:37 pm
Does anyone know anything about the Navy HPSP? I understand you enter an internship and become a GMO after you graduate. What does this mean for you as a primary care physician? What are residency options like and what are you really likely to end up doing?
silvanus said,
February 5, 2009 at 6:09 pm
my son is a recent undergrad, i was recommending the HPSP to him. After reading all these comment I am very confused. Someone mention that the training is inferior, is this true. Someone please help me out here with these concerns. 1. He wants to be an orthopedic surgeon. 2. He don’t want to have a huge debt upon graduation. 3. How long after graduation will he be obligated to the military before he can go into civillian practice. Someone please help me out here.
Half M.D.: Why were you recommending HPSP to him if you have no experience with it? Furthermore, why are you the one writing me and not him? You need to list which branch of service he is interested in; but general, 1. he may not be allowed to do orthopedics and instead be forced into general medical practice or flight medicine. 2. Take the debt and never look back. An orthopod can pay off $200,000 in a few years. 3. There is a year-for-year obligation. If your son takes a four-year scholarship, the payback is four years as an attending. Residency does not count toward the payback.
DecidingWhichPath said,
February 21, 2009 at 12:58 pm
Can anyone answer this question for me? Are the calculations above from halfmd inclusive of Insurance Premiums? I am a post graduate student thinking about going back to med school, and am deciding whether or not 1. I want to fund my education rather than take out a loan, 2. practice without malpractice insurance ripping me a new a hole, 3. help out people (of course).
Of course, as another poster mentioned, I would also love to travel all over and see/help out those who selflessly are giving their lives up for us.
I have heard that military doctors do not need to pay premiums, and that this usually is a roadblock in paying back student debts. Is this assumption wrong?
Thanks
Half M.D.: Those numbers do include malpractice insurance. If you’re taking home $200,000 a year, the roadblock to paying back student loans is poor spending and has little to do with the cost of malpractice.
Mike said,
March 19, 2009 at 12:52 am
These numbers are TOTALLY wrong.
In all your calculations, you forgot to add interests accruing on your loans, the tax differences in pay, tax-free income in the military (VSP, BAH, BAS). In the military you don’t need malpractice insurance. I’m not a recruiter for the military but based solely on numbers, the military comes out ahead of most specialty except possibly the highest paying ones like opth, derm, ent, radio, plastics, etc.
I just did simply calculation of the general surgery military vs. civilian pay based on your existing numbers.
At year 9 of military, you will have earned $870817 minus an average of 27% income tax and you NET $635,696
At year 9 of civilian, you will have earned $1,200,000 minus an average of 30% tax which is because of higher tax bracket for a net of $840,000.
$840,000 – $635,696 = $204,304 NET more wealth for a civilian surgeon however your education cost $208,000 + interest so in essence it is a complete wash.
The calculations above also don’t include HPSP stipend and sign-on bonus etc. But the bottom line is the military option is indeed an equal to better financial total package depending on your specialty and of course, your medical school.
Jambony said,
April 9, 2009 at 2:03 pm
these numbers do not include loan interest? That is the biggest part of loan repayment. Has anyone seen a more comprehensive calculation of the two financial paths? thanks.
Military Surgeon said,
May 9, 2009 at 9:10 am
I am a HPSP scholarship winner and military surgeon who is getting out after my 4-year commitment. Accounting for tax-free portions of my pay, I make roughly $160,000 a year. Although, in my last year of commitment I did not take the fall specialty bonus ($36,000) so I could get out at the earliest possible time. Note: To receive all physician bonuses an additional 3 months must be served, taking total service to 4.25 years. In effect, the HPSP is really a 4.25 year time commitment, if you want all the bonuses.
In regards to the above math, the calculations are not perfect but the conclusions are correct. If you go into primary care you are money ahead, if you’re a surgeon you’re money behind. Roughly, any specialty that makes over $300,000 a year will be money behind (e.g., anesthesia, radiology, cardiology, GI).
More importantly, you sacrifice choice by taking the military scholarship. The key phrase is “needs of the military” and it comes to bear when you make a career choice, preferred residency choice, choice of fellowship and place of practice. The military does not have to allow you to train in your specific medical area of interest (e.g., orthopedics), may not allow you to pursue a civilian residency (e.g., UCSF internal medicine residency vs. military residency), does not typically allow for fellowship training straight from residency and gives little choice in where you live.
The scholarship hurts those students who wish to pursue a prestigious civilian residency, because you will probably get chosen for a military residency. I’ve seen this happen with medical students who graduate at the top of their class and are competitive enough to attend top-notch residencies, but are chosen to complete military residencies. It affects medical students pursuing popular residencies that the military only needs a set amount. I’ve seen this happen with medical students desiring ophthalmology, orthopedics, and neurosurgery residencies. They were not granted permission to train in these residencies straight from medical school. So, they either choose a different residency that the military needed, or served as a general medical officer for 2-years and made to reapply to the military residency selection process in hopes of being granted permission to pursue a residency in their chosen career field. The above also holds true for applying for fellowships (e.g., vascular surgery, cardiothoracic surgery). You must understand, once you accept the scholarship you will lose ultimate decision making capacity over your career.
If you can accept the following: 1. You lose decision making capacity over your career, 2. As surgeons you will be deployed overseas (~20% of my time spent in war zone, 10 of 48 months); 3. DOD/VA disability does not take into account your physician bonuses, therefore if you get hurt you will be compensated at current rank only which may not be enough to support your family, 4. Only one life insurance company currently insures active duty military members (USAA, Max policy $1mill + 400k from military = 1.4 mill total) which may not be enough to support your family, 5. Doctors have been killed-in-action during the current conflicts – Then I would make these recommendations.
Recommendations:
1. If you want to serve your country, take the scholarship.
2. If you know you are going into primary care (e.g., family practice, pediatrics. internal medicine) and know that you do not want to complete a civilian residency – Take the scholarship.
3. If you know you want to be a surgeon – Don’t take the scholarship. Get into a civilian residency, make sure you don’t want to complete a fellowship, then look into the Military Financial Assistance Program (FAP). In fact, If you’ve attend a state medical school, you might actually be money ahead with the FAP route (vs. HPSP).
Michelle said,
May 18, 2009 at 5:40 pm
When reading this, I must remember that it was created by a med student/doctor. So I will keep in mind a lack of business knowledge in my comments. Time value of money is a huge thing here. So are taxes. Some of the pay a military doc gets are tax exempt, like housing and food allowances. That aside, the main thing missing here is the cost of health insurance. All of my husband’s classmates that went the civilian route are paying some if not all of their health insurance as residents. That will continue after graduation from residency.
My advice to anyone reading this site, listen to what Military Surgeon said. Doctors deploy just like the rest of the military. There are dangers and if that is not something you want to do then don’t take the HPSP scholarship. Also, the military is a way of life, not just a job. While the medical corp is not like the regular military, they still have rules. You have to cut your hair and wear a uniform. I, as a thirtysomething married to someone who spent 8 years enlisted, was not surprised by this. But you would be surprised how many 26 year olds take exception with these simple things. If you are seriously considering this option, talk to a military resident or military doc to find out what it is really like.
Half M.D.: You know residents that are paying health insurance? Med students do, but residencies cover most—if not all—of the expenses, similar to many other civilian jobs. And yes, the full coverage that the military provides is certainly a plus of working there. I know of one physician who has a child with special needs who has to stay in the military for nothing else than the free healthcare.
Dean said,
June 27, 2009 at 1:03 pm
Military Surgeon,
Can you explain more to me about the FAP program and how it may be a better option than the HPSP?
Kevin said,
July 2, 2009 at 6:48 pm
Think makes a very good point. I know all of you didn’t become a doctor for the sole purpose of making money, that would be a poor decision. The amount of studying and work that goes into completing the four years of medical school, passing three medical licensing board examinations, completing 3-9 years of grueling and sleepless residency, passing your specialty licensing boards, continuing medical education, and the rigorous work schedule you will have for the rest of your life wouldn’t be worth it if you didn’t enjoy practicing medicine. (Physicians have the highest suicide rate of all professionals). If money is the main reason you want to practice medicine, I wouldn’t want to work with you.
The military offers a way to serve your country while receiving some very competitive financial benefits. Just as money shouldn’t drive you to choose medicine as a career, it should not drive you to join the military. It is a very different life style and is demanding in a unique way.
I would now like to point out some things this site did not include in the calculations and address some fallacies (I will focus on the Navy because that is the branch I am in):
1. The Navy (I cannot say about other branches) will not force you into a residency you do not want. If you do not get the residency you want, you can do a GMO tour, flight surgery, transitional year, undersea medicine, or defer to civilian residency. As the Navy is getting rid of GMO tours, civilian deferments will be much more common.
2. As others pointed out, student loans rack up huge amounts of interest.
3. Investing the positive cash flow you have during medical school means you to EARN interest. Over 7 to 13 years, this can add up.
4. There is now a $20,000 signing bonus
5. Monthly stipend payments are $1981 as of July 2009
6. The tax benefits are about $6000 PER YEAR (Again, consider interest earned by investing this)
7. You can’t factor in any loans you may take out in addition to your stipend while on HPSP because you would be taking the same amount of money out in loans as a civilian.
8. Cost of living in the military is drastically lower than in the civilian world. You get discounts everywhere, all your purchases at exchanges and commissaries are tax free, these places usually have very good deals, free health insurance, and no malpractice.
Bottom line; the military is not for making more money, it is a way to serve your country, gain some incredible experience, meet incredible people, and offer a medical career with salaries that are COMPETITIVE with civilian practice, not necessarily better.
AFHPSP said,
September 2, 2010 at 5:06 am
Hello,
I have to write something when I read this post. Becoming the military doc is less about money and more about commitment. I will not discuss the financial issues since there are too many factors concerning different school tuition, loan interest rate, military bonus, specialties..etc…
You got the opportunities to do something great and this can not be calculated in term of money. In addition, HPSP program gives medical student “peace of mind” when you are in medical school. I am a first year student and I can tell you straight out that I don’t have to worry at all about tuition every semester or living expense every month. The stipend is roughly $2000 but it is very adequate if you live cheap and don’t spend lavishly.
What is even better about HPSP is that it suits a lot of married medical students with dependents. It is one thing to worry about yourself, but having kids while you are in med school is an extreme burden. There are additional dependent allowances if you are married, even though it is not much. It helps you to focus in medical school while not worrying about your family’s welfare. This is the biggest factor that influence many married med student to join the military. I went through officer training at Maxwell AFB and I can tell you that a majority of HPSP students are in it because they are married and want “peace of mind” while you are in med school
Med school is intense and hard. Having not to worry about money is the biggest factor that help you to do well and excel in becoming a doctor. This is something that can’t be put into money. So please don’t join the military if you think about money. YOU ARE DEAD WRONG!!!!!
Manny said,
November 19, 2010 at 10:38 pm
Question for the Military MDs on this post. Can’t you simply get out after your obligation and start making more money in the private sector? I may be naive, but it seems like if you’re worried about being “behind” in money then that’s the only reason as to why someone would not do consider the HPSP. Because one you finish your Active Duty obligation, you can simply work as a civilian and see increases to your salary (and taxes lol).
Jon said,
February 14, 2011 at 1:28 am
Manny,
Ditto.
-Jon
Someone please answer Manny’s question about Leaving for the Private Sector.
ICEMAN720 said,
March 23, 2011 at 11:44 am
@Manny,
I am on the same page with you and AFHPSP. I for one am a patriot, and I believe the honor aspect is worth more than anything else. My only obstacle is providing for my family. The HPSP is not a bargain by any means, it is an honorable and reasonable option if you are looking for help by serving the country.
HOWEVER, from what I have read elsewhere, ie. StudenDoc, HalfMD etc..
Military is not for those prestigious med school students that want a prestigious residency, a prestigious fellowship and a prestigious practice because the military board makes all final decisions on the who what when where and “how high”.
AND so because you cannot pick your residency with 100% certainty some early pre-doc’s get put somewhere and don’t get a lot of experience and this makes it harder for them to compete with civ pre-docs that are looking for fellowships or jobs.
ALSO, the 4 years after medical school the civ docs definitely will earn more money than the HPSP doc in his/her first 4 years.
***The BIG question is, even if a mil doc can’t “catch up” can the mil doc compete money wise after the 4 years with a civ doc?***
Nontrad said,
April 26, 2011 at 10:48 pm
I am 41 and completing my prerequisites toward medical school. The HSPS is attractive to me because of my age (assuming I can get a waiver). I will finish med school at 47 and finish a residency no sooner than 50. I can’t spend 10-20 years paying off a huge student loan. You could argue that I could pay off the loan in the civilian world in the same time that I would be spending in the military, but that is unlikely with the three year residency specialties, which aren’t very lucrative(maybe with E.M.). I’d like to specialize, but at my age I’ll be lucky to become a doctor at all; it doesn’t make sense to consider long residencies/fellowships.
But perhaps the biggest advantage is the stipend and bonus. I will have to quit my job and my wife will have to be the sole bread winner for our family of four. The stipend, officer pay, and bonus are roughly $30,000/year. That is a huge weight off the shoulders of my wife.
I’m not in it for the money, but at my age I have to consider financials. I agree with some of the previous posters – the accruing interest, during and after residency, are a variable that has to be considered.
Another factor at my age is the tuition of particular schools. Without the HSPS I’ll be limited to lower tuition schools, which may not accept me. I’m only going to have about 15-20 years of active career life available after residency – I can’t have a $300,000 tuition bill. With HSPS I can attend any school regardless of tuition.
FutureReliefDoc said,
May 6, 2011 at 6:56 pm
I will be starting medical school in August, and I’ve accepted an HSPS scholarship from the Air Force. Before signing I read through a lot of forum discussions. Ultimately I decided it was right for me because:
1. My school’s total cost per year is approximately $54,000. This total does not include living expenses. The living stipend for this year is $2,100 a month so my scholarship is worth around 80K a year. I’ll also get officer pay during my active duty commitments in the summers.
2. I have no savings, and about 40kd of debt (undergraduate loans and a car loan). My dad is a trucker without a college education and my mom is a social worker so family contributions are not an option.
3. I am not going into medicine for the money. My ultimate goal is to work for an organization like Doctors Without Borders, or Partners in Health. Traveling to random places after I graduate isn’t deterrent for me. It’s a resume builder.
4. I might want to go into a “low paying” specialty like family or internal medicine.
5. Members of my family have served in the military, and although I don’t think I will want to make a career of Air Force, I don’t mind serving.
I really went back and forth on this decision. I’m a pretty liberal thinking, free spirited person, and I never saw myself as the military type. However, I weighed the idea of practicing for the Air Force against the prospect of graduating with upwards of 350k of debt and having to work for a large HMO in order to make my student loan payments. I don’t see a whole lot of freedom going that route either.
One thing I read over and over is “if you’re doing it for the money, don’t!” but lots of people join\enlist in the military for the money. Serving has always been a way of getting a step up in our socio-economic system. I figure I’m just like all the guys and gals enlisting to make a better life for themselves, except I get to fulfill my dream of becoming a doctor at the same time. I’m looking at my military obligation as an opportunity and an adventure. I’ll take the good with the bad, and make the best of it.
Lauren said,
February 8, 2012 at 2:40 pm
I am a junior undergrad looking to go to medical school and am interested in the HSPS Naval Scholarship. I am hoping to go into trauma surgery and I want to work with Doctors without Borders and/or Partners in Health. I’m not looking to medicine to gain prestige or tons of money. I am concerned when I see that people are saying you don’t necessarily get to determine your own career. Is there any more advice out there regarding trauma surgery and experiences you get through this program?
isdh said,
February 29, 2012 at 5:54 pm
you’re forgetting something important.. military doc’s don’t pay malpractice insurance, civilian doc’s do. factor that into your calculations, see what happens. probably totally different. civilian doc’s usually pay around 25% of their salary into malpractice, more for surgeons.
JTAC WIFE said,
April 3, 2012 at 8:54 pm
Does anyone have stat’s on a neurologist residency in the mil? Thanks
JW said,
July 11, 2012 at 2:15 pm
Can anyone provide any insight as to whether or not doctors getting out of the military and entering the civilian work force do as well as their civilian counterparts financially?
Is it difficult finding a civilian job after leaving military medical service?
Does military service in any particular specialty make you more competitive for a civilian position?
Thanks you in advance for anyone able to provide any information regarding the above. I chose to go with the scholarship after quite a bit of thinking and just want to know a bit more more about what potential complications I may encounter should I choose to leave after my four year service.
Thanks!
Victor Johnson said,
August 5, 2012 at 12:29 pm
Hi Is there a way to contact you (the Blog Owner)? Thanks!
Ameera said,
August 5, 2012 at 8:04 pm
Can anyone answer JW’s question? I am curious.
Future - Navy - Gal said,
August 30, 2012 at 1:56 pm
I’m also a jr undergrad looking at med school. I’ve been considering the HSPS scholarship. I’m married, no kids, and am leaning towards internal medicine (would like to avoid the 80hr/wk schedule, since i’d love to spend time with my future kids). My only problem is that my husband is not an american citizen, and I was wondering how that would affect a life living on the base?
Secondly, I’d love for someone to answer JW’s question about civilian practice after leaving military
3rd – what about becoming a reserve for the navy? Instead of active duty? How many years would you have to put in after residency?
Thanks in advance
Kathy said,
September 24, 2012 at 10:33 am
I’m proud to serve my country and I hate that every single time I’m looking for information your stupid blog comes up in my google search. Keep your journaling to yourself and stop trying to discourage others from serving their country.
deltadoc said,
November 11, 2012 at 12:59 pm
good information…take it for what its worth and make up your own mind…in the end, financial gain should not be your top reason for going the military route…nonetheless, if you have a healthy combination of patriotism and the need to get financial help for med school, it may be a viable option for you…only you and you alone can decide that
cengin said,
December 3, 2012 at 11:08 am
I’d really like to know the answer to JW’s question as well!
cengin said,
December 3, 2012 at 11:13 am
Also, I find this one much more comprehensive.
http://whitecoatinvestor.com/personal-finance/should-i-join-the-military-to-pay-for-medical-school/
Jeremy said,
January 23, 2013 at 1:39 am
Good job building the graph, I too obsess over planning. However, (and someone may have pointed this out already, so my apologies if so) but I came to a different conclusion when you factor in the interest that you accumulate, according to your figures it would be approx $341,000 to pay for your 4 years assuming all of it is at the federal 6.8% interest rate (don’t forget private loans are higher and federal has a limit somewhere below 250k). Also, that’s assuming you pay it all of in 4 years after residency (same time as the hpsp obligation) which prob wouldn’t be true of your avg loan recipient (so the total payment is actually greater than previously stated). Many of my friends that are residents say that they cant afford to even pay all of the interest on their loans and still survive off of a 45k salary, so hpsp does provide less stress there. Additionally, (I am not there at this point in time so not 100%) but I’ve read from many to learn to “work” the system, ie taking your built up leave time from your residency and getting some extra bucks moonlighting…could bump your salary at least 10k a year (and not requiring any more hours). I just think there’s more that needs to be considered if you look at it solely from a financial perspective. Don’t forget the signing bonus, lol.
PAgrad said,
June 26, 2013 at 12:55 pm
It has been a terrible experience from start to finish. My pay and scholarship started about 2 months after school started so I was responsible for all the finances up to that point with no reimbursement. After graduation I got placed in academic hold without pay or benefits. Pay and expenses stopped 2 months before graduation and I have again been responsible for expenses. No health insurance, bills in default, and because I can be activated at any time with only 24 hours notice, I am unable to contract into a civilian job. If you call the HPSP office, theyll tell you to your face “you just need to wait like everybody else.”
Worst financial move of my life was joining the Navy.
RadMan said,
February 25, 2014 at 7:43 pm
Unfortunately tuition is now 50,000 😦
MedHopeful said,
March 24, 2014 at 10:49 am
Nontrad: I know your post was quite some time ago (2011) so I don’t know if you even see or get this message but I am curious as to what happened for you after all. I am 38 right now and in pretty much the exact same situation. I have a family et al & I want to become a physician. I also am not in it for the money like you say and HPSP would be an awesome opportunity to get into medicine without the financial burden. Plus I would love the idea of serving. I have some of the pre-reqs but still need some others. The soonest I would be able to finish the 4 years of med school would be when I’m 44. 42 seems to be the cut-off age. Were you able to get a waiver and participate in HPSP?
Samir Desai said,
December 21, 2014 at 11:42 pm
Military recruiters do a great job of getting the word out about HPSP, and it seems as if I’m always fielding questions about the pros and cons of the program with newly accepted medical students. It’s good to have a post like yours that breaks things down. You may also be interested in reading about economic analysis of HPSP for neurosurgeons:
http://www.ncbi.nlm.nih.gov/pubmed/21441836
kaleb said,
June 20, 2015 at 6:33 am
Ok I’m a E-4 living in San Diego County And I make around 60k after all my pay not just base.
MilANDCivDoc said,
August 30, 2015 at 9:13 am
I have done AFHPSP, residency, served my time, and am a civilian doc, so I can speak with experience here.
There are several issues involved in choosing military medicine, but one is the most important: the deception involved in selling the program and the disregard for the professional well being of the physician.
In summary:
Deception:
-Commitment:
–There are many hidden ways the military service attempts to increase commitment beyond the original agreed to time:
—GMO Tours: Effectively increase your commitment if you are not selected for residency and then complete it later; increase BY SEVERAL YEARS
—Training: Often, residencies or fellowships may only be offered “sponsored”, which means one-for-one additional time
—Fellowships: Many fields require training past residency. This incurs substantial additional time AND also incurs financial penalty by delaying when a bonus can be taken
-Opportunity:
–Training in many fields can be extremely limited. Opportunity for good training may be minimal. Opportunity for top-notch renown training will either be zero OR will come with a long commitment (sponsored training)
-Leaving the military:
–Like a post above, if you want to get out in July at the end of your time, it will cost you $20K to $36K. If you stay until October you can get this money. Why is 3 months a big deal? It is a HUGE deal — the residency and fellowship cycle as well as the job cycle is in July. If you get out in October you CANNOT do a fellowship directly from active duty. If you get out in October, all of the new grads took the jobs that were open in July.
None of this is disclosed or even easy to figure out, and it is so important to anyone agreeing to serve.
Disregard:
If you pour your sweat and blood into graduating medical school, you might become a Physician Assistant Equivalent for 4 years if you do not get your residency the first time, OR if you want a residency that they force you to do GMO first for and do not want to extend your commitment.
Second, if you do get that residency and work all those endless nights to become a stellar surgeon, etc, the Army might send you to be a Physician Assistant Equivalent doing primary care (Brigade Surgeon) for 3 years. How much skill will you lose after 3 years?
Work conditions: You might be placed in a situation where the care you provide is below what you feel acceptable due to facility, manning, and/or resource constraints, or the fact that you are sent somewhere alone directly from training. This will create a lot of stress and dissatisfaction.
Work conditions: You might be forced to take call Q3, Q2, or even Q1 as an attending due to inadequate manning. You might be forced to take call as an attending to perform the job of a non-physician technician because the technician is a civilian and cannot be forced to take call. Think force reductions and manning shortfalls.
Economic Theory:
Military pilots only have economic value flying planes, so the risk of abuse, forcing a pilot to work so much he is miserable is low, as no one really stands to benefit from that.
Physicians have economic value to everyone who can use their services, and those who can use their services can also force them to work more, for free. There is an incentive to over-work and abuse the physician, but not the pilot, and only in the military can you be forced to work more for free. Pilots have crew-rest and work hour restrictions to ensure adequate rest. Physicians do not — I can tell a story of several physicians who were not allowed to take any vacation for a year and work continual Q2 call due to a manning shortage — a manning shortage that could have been fixed with the proper funding, but it is cheaper to work them more.
Money: Yes, you will make more money as a civilian unless you are in one of a few fields, but then if you account for hours worked, you may still make less in the military if there is a lot of forced call etc in those few fields. Also, military pay over a career only becomes competitive if you take repeated 4-year contracts and retire. If you want to not always be under a 4-year contract, the pay will be abysmal in comparison. I.e. you have to take HPSP scholarship commitments many times over your career and can never have a time with true choice. You only get paid for abrogation of choice, not skill as a physician.
Bottom line:
My main issue is that the system created is so complex that it is difficult to understand and make an economic decision based upon. Furthermore, is is difficult to trust that you will be treated fairly during your agreed upon service.
(C) 2015
Sean said,
December 19, 2015 at 1:35 pm
How in the world do you arrive at a realistic conclusion while simultaneously ignoring reality?
Right from the start, the bias OP invalidated his entire argument by stating he was ignoring reality (i.e.) All available metrics-interest rates, common expenses of doctors, etc Then, he concludes the military route is not the best for all physician pathways after showing one of his first examples that it beat the civilian model even 10 years out. By far this is one of the weakest arguments I’ve seen with poorly applied statistics to prove an invalid point.
Luckily my colleagues have taken a moment in the past to provide some of the great reasons to serve with us.
This article was published in 2007. The HPSP program has seen much over haul-especially at service branch levels.
If you are an undergraduate trying to properly vet out if an Air Force Scholarship is the best route for your medical aspirations, please contact me with all your questions and concerns. I will guarantee you a pressure free environment, and as much information in black and white as I can source from all channels.
Get real time information on the U.S. Air Force Health Professions Scholarship Program by contacting me directly at:
Sean.triglia@us.af.mil
New York City Based
U.S. Air Force
Health Professions Recruiter
26 Federal Plaza
New York, NY 10278
Been there done that. said,
July 23, 2017 at 1:16 pm
What was left out in your analysis is the time value of money or compound interest. The $30000 tuition cannot simply be multiplied by four. Student loan interest is incurred from the day of funding lets say 6.5% annually which turns the $120,000. into approx. $136,800 after four years, now let say you defer those payment in residency for three year as you will not be able to make the payments on $136,800. The $136,800 after another three years in now $165,200. Obviously that is just the tuition cost. The HSPS value is closer to $240,000 with the monthly stipend not the $208,000 stated.