What the civilian match means to HPSP students

March 24, 2008 at 9:08 pm (Military medicine)

I watched my university’s Match with great anticipation. As a member of the military, I’m required to apply for military residency at the beginning of my fourth year. While the Air Force does grant deferrals to attend civilian programs, the military residencies have first dibs on the applicants.

I took some numbers from last week’s Match in emergency medicine and came up with the following:

1,235 U.S. seniors applied for 1,475 spots in emergency medicine nationwide. Of these seniors, 1,128 matched (91%), and an additional 22 seniors went into combined programs such as internal medicine/emergency medicine. 30 residency spots went unfilled.

Further, I went through the AAMC’s data on the applicants to EM programs. The average STEP I score was 220, half of the applicants did not have publications, and the vast majority did not belong to AOA.

In conclusion, looking over the board scores and other application data from last year, I’m reasonably sure that if I were a civilian, I would have no problem matching into EM.

But I’m in the military—which means that I only have a 30-50% chance of matching when I apply next year. That’s something the recruiters never told me when I took the HPSP scholarship. More likely, I will be forced to into a one-year internship and then released into the world as a flight surgeon. Just think, my career goals are about as far removed from primary care as they can get. And so what is the Air Force going to do? Force me into primary care along with 70 other fourth year medical students who had other dreams.



  1. MSG said,

    One of my friends took the Air Force route and has regretted it severely this year. She wanted to match into OB/Gyn, was put into Peds instead (which she hates). After a great deal of calling and begging she was told that she could do one year of surgery and then try to match again next year. She’s really upset that she took this route along with her parents. She has very little choice. Unless you want to be in the military I don’t think this is a good option.

  2. CT said,

    My application was in to be considered when my HPSP board was to meet next and I pulled out, precisely because I was pretty sure I was going to want to do something competitive and I didn’t want to burn myself further.

    I really want to serve, although not make a career of military service. But even with the loans I’m incurring I just think looking into FAP or some of the military reserve medical education loan repayment programs are better options. Especially since I’m going to a relatively “cheap” state school. By then I’ll be out in residency and if the military doesn’t have a need for whatever specialty I’m training in then that is their problem.

    That said, my school has one of the biggest classes of HPSP students in the country. Every year we send a bunch of kids into the military and despite some of the unique obstacles of military medicine, and the military match in particular, it really does seem that most students are happy. I’m sure things will work out.

  3. REO SpeedDealer said,

    Just like 94% of Air Force docs, do your time and get out at the earliest opportunity. You’ll have no trouble getting a good civilian residency, it will just be 4 years later than you wanted. Be sure to pass your experience on to other students at your school so they don’t fall into the same trap.

  4. halfmd said,

    What’s bad is that I’ve told numerous students about my concerns with the flight surgery track (I’m not quite as blunt to strangers in person as I am on this website). I—along with every attending and resident on SDN—post numerous messages online to try and steer potential applicants away from HPSP. Yet despite all of the negative things that I say about the program, at least 2-3 people from my school are joining each year, not to mention all of the first-year medical students on the student doctor network who gleefully announced that they have just signed their contacts. There is certainly no shortage of students who are terrified of debt and willingly sign away their lives to the military.

  5. former AF now MS-1 said,

    Don’t be too negative about it at this stage. Yes, you might do a one-year transitional internship and then two-three years as a flight surgeon. You can’t do a thing about it.

    The secret to being happy in the military is to like what you get, because you’re not likely to get what you like. So look at it as an opportunity to (1) be in a fighter squadron (2) live in England, Germany, Italy, Japan, South Korea, or some other place that none of your classmates are ever going to live and (3) be a little older and more mature when you return to do the residency of your dreams.

    I’m WAY behind my age group in med school because I spent some years on active duty first. I had four stations in three different countries and visited 13 others during that time. In the end, I’m happy I did.

    And don’t discount the reduced stress of not being $200,000 in debt. The grass is always greener and all that.

    I’m not saying the military match system is perfect, or even good — I’m saying that it’s not worth considering that question. You can either make the most of the chances to enjoy stuff, or not. That’s pretty much the only choice the Air Force leaves most of us.

  6. Zach said,

    I’m a PCOM-GA student who is also regretting their HPSP Air Force scholarship. Do you happen to know what percentage of those with the scholarship actually end up doing a flight surgeon tour? Or get civilian deferrals?

    Either way, good luck. Your chances may be lower than civilian side, but don’t resign yourself to GMO just yet. You never know.

  7. halfmd said,

    I ran through the numbers and found that 25% of medical students get placed into one-year internships, presumably leading to flight medicine stints. 37% of student applicants were awarded deferrals—more than half of which were for internships only.

    So in summary, not only are Air Force students required to enter primary care against their will with only one year of training, they are also left on their own to find residency locations.

  8. CC said,

    The AF in particular is very primary care oriented compared to the Army. There are specialty slots available, but there are not many compared to the number of IM, Family, and Peds.

    EM was pretty competitive in this year’s AF match. However, what is competitive changes year to year and can be rather unpredictable. If you are forced into a transitional internship, you can always apply for the military match for the following year.

  9. Callie said,

    It is what you make it. There are ways to make sure that you are not to behind from your peers. If you do your transitional year make sure it is in the PGY-1 requirement for the residency that you want to pursue. Also on the applications you rank your choices so for the woman that got suck in peds she put it on her application they didn’t just stick her there because she took the stop of someone I am sure wanted it. On the app. you rank your residency choices so if you want to defer thats 1 you want to go to travis thats 2 etc and then you also have to rank which PGY-1 you would do if you are not matched into the residency. Also if you think about it this way: total you where going to spend at least 8 years in the military if you matched with a military residency. If you don’t match and get out right away after your pay back you are still spending at least 2-4 more years at a residency program and you should be able to match as a PGY-2 if that is the way that you want to go. In the end it is about the same about of time. Before you start the whole process you should call the head person that coordinates all of it and he/she will be able to give you the in’s and out’s to make sure that you are going in the right direction, just need to be smart and scout out your chances.

  10. Jay said,

    The GMO/Flight Surg/Dive Medicine possibility is what steered me away from the Air Force and the Navy, I chose the Army specifically because I did not want to be delayed into residency. As a non-traditional applicant (older) I did have an advantage that the services rarely delay the older grads, usually deferring to civilian residency if not matched into a military program.

  11. Chris said,

    I am about to enter med school 2009, but everytime I look at the costs for attendance I grow more worried about the debt I will accumulate. My prospective med school costs around 65,000 a year. Does that mean I will end up with an approximate debt of $260,000 in principal plus the compounded interested during all years that I defer?

    Could anyone please give me some information with a real breakdown on the numbers to show that life is still possible with this kind of debt? how long does it take for a physician to pay all that back?

    For this reason, I’ve been looking at HPSP, but that seems like a fatal mistake?

    Half M.D.: You aren’t alone. Lots of docs worry about the debt, but they all pull through. You can expect to live a comfortable lifestyle and pay back your loans over the course of 20 years. Joining HPSP for any reason other than wanting to be in the military is a bad idea. There are public health sector scholarships if you’re willing to do primary care or ob/gyn.

  12. Angie said,

    When do students in the military match find our where they will be doing their residency?

    Half M.D.: Mid-December

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