I recently wrote an article about some of the misconceptions that medical students have regarding military medicine. I want to drive home the point about having a lifetime net loss of income by taking the HPSP scholarship, working for four years as a flight surgeon, and then getting out to pursue residency training. I created the pretty graph below to illustrate just how much money you will lose by taking this scholarship.
Don’t blow off money as if it’s no big deal. Many of the premeds who read this blog are 21-years-old or younger, single, and have been living in student poverty for the past few years. Granted, $95,000 a year as a flight surgeon will enable you to do pretty well if you’re single and living in an area like Texas where housing is cheap. If you’re married to a housewife, have two children, and are stationed in San Diego, $95,000 a year isn’t going to get you very far. Realize that many things change during medical school and residency. Your priorities at the age of 21 are going to be vastly different than your priorities at the age of 27.
Over the past few months I’ve been collecting questions from first-year medical students about statements they’ve heard regarding military medicine. Much of the information that they’ve received from recruiters has turned out to be false. If you are considering a career in military medicine, I urge you to carefully consider the consequences of taking the scholarship. Here are some of the lies that I’ve heard:
“There is a 98% match rate in the military.” — There is a 75% match rate in the Air Force, and the Navy is much lower. People who do not match through the military are usually forced to become general medical officers, dive medicine officers, or flight surgeons.
“If you don’t match in the military, you can always try the civilian route.” — Absolutely false. If you don’t match in the military, you don’t match at all. You’re certainly welcome to apply for a civilian deferral at the time that you apply to the military match. However, there is no guarantee that you will ever be granted a deferral to the civilian world. The only determinant of whether or not you get a civilian deferral is through the military match. If you fail here, you won’t be training in the civilian world in any specialty.
“Everyone is guaranteed a residency.” — Not quite. Everyone is guaranteed an internship. Only 75% will get a full residency.
“You can never be forced into a specialty that you don’t want to practice.” — Partially true. The military can force you to become a general medical officer or a flight surgeon as these two professions are not considered true specialties by the military. You cannot, however, be forced into a categorical residency program. A note about flight surgeons: you will receive specific training to their discipline in the form of the aerospace medicine primary course. Although I would like to believe that unique training is a qualification for a specialist, the military does not share my thoughts.
“Flight surgery is the greatest thing since sliced bread.” — That depends on what you want out of life. If you want to be a general practitioner for pilots and their families, then you might enjoy flight medicine. However, you will not become a licensed pilot simply by attending the aerospace medicine primary course. And despite the term “surgery,” this field of medicine has nothing to do with operating.
“You can operate in the back of an aircraft.” — Are you kidding me? Hell, I was even told that flight surgery was a route that orthopedic surgeons choose to enter so that they can design more ergonomic planes.
“You will financially break even if you take a scholarship.” — Absolutely false if you want to enter any profession other than primary care. Let’s say that the Air Force spends $250,000 on my medical school education and then forces me to become a flight surgeon, making about $95,000 a year. If I had opted for taking out student loans and then going for residency and securing a job that pays $200,000 a year, my net gain would have been $330,000 over my lifetime. With a $300,000 job, the net gain would be $830,000. Simply put, I will lose over half a million dollars by taking this scholarship.
If I haven’t deterred you from considering the scholarship, at least ask your recruiter for the names of several physicians who have entered the military through the HPSP program. If he can’t give you any names, hang up immediately and never return his phone calls.