Financial analysis of the Health Professions Scholarship Program

March 23, 2007 at 5:50 pm (Military medicine)

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:

  1. No deployments
  2. I used my zip code (a rather expensive area to live) for the Pay Calculator
  3. No inflation or changes in salary for either civilian doctors or military personnel.
  4. No interest rates on student loans.
  5. The military doctor has no prior experience and gets promoted to major after six years in service.

Pay chart for internal medicine, military route

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.

Pay chart for internal medicine, civilian route

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:

Pay chart for general surgery, military route

Pay chart for general surgery, civilian route

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:

Pay chart for radiology, military route

Pay chart for radiology, civilian route

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.


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