Half MD: “That’s a pretty disheartening statistic to read, especially given that more than 94% of applicants match through the civilian route. I remember being a naive pre-med who bought into the lies told by recruiters that 98% of medical students enter the specialty of their dreams. If I had known then that I’m about to spend several years as a general practitioner, I never would have accepted the scholarship.”
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I don’t know how it works in the Air Force, but I went through the Navy AFHPSP (Armed Forces Health Profession Scholarship Program) back in the eighties. After a basic surgical internship, the likelihood of being accepted directly into a residency program was pretty low. Why? Because the armed services need OPERATIONAL physicians–folks to go out on deployments, like the rest of the military, to fullfill missions. I found it a great opportunity to get off the beaten path of High School-College-Med School-Internship-Residency-Practice-Retire. I became a Naval Flight Surgeon after a six month period of training in Pensacola (including flight training), and was assigned to a Marine squadron. I went to Saudi Arabia with the Marines in the first Gulf War. I had experiiences I would never have had if I weren’t in the military, not to mention much less debt. And once I finished my operational tour as a Flight Surgoen (three years), I commenced a very fine Navy surgical residency. I am now in private practice after having completed a commitment following my residency, and I miss the Navy. In fact, I would advise those who want to match up in immediately after med school to not be in such a hurry–it ain’t no great shakes when you get to private practice.
Hmmm.
It’s great when it works, which it doesn’t for many, unfortunately. The sad fact is that recruiters sell residency availability without bothering to mention how few residency slots there actually are beyond the PGY1 year. I too went through the HPSP program in the 80s and did a surgery internship and a flight surgery tour (and a half) waiting for my slot in Navy GME while I watched the Navy cut the numbers of slots available in my chosen specialty by 75%. That did not make for happy me, nor for a lot of others either. I left the service to do my subspecialty surgery residency and fellowship.
The truth is that the military scholarships are designed primarily to generate lots of GMOs who then must leave the service for lack of adequate opportunities at the PGY2 level. Those folks aren’t uncompetitive either, most go on to place well on the civilian side.
Flight surgery can be a fun experience, but much depends on your assignment and how well your military organizations look after your interests–some make a better effort than others.
On balance, unless you want to spend time away from training for several years right after your internship, (and why, after all don’t you want to be well-trained?) then the HPSP program is not such a good idea. Most graduating interns could use a couple months vacation, which they never get, but they don’t need three or four years away from an academic training environment at that point in their formation as physicians. That really isn’t so good, and for the same reason is why HPSP isn’t so good either.
The fact that any medical students in the HPSP program are compelled to practice with only one year of postgraduate training rather than being permitted to complete a residency is the larger fact that deserves scrutiny. And it isn’t just the Air Force that is guilty of these practices, the other service branches are equally notorious for the same thing. It is a condemnable practice no matter what color the uniform.
I’m not clear on this. Why does a medical student on an Air Force scholarship need to match in an Air Force residency? Or for that matter, ANY military residency?
I thought the deal was one year service for each year of medical school supported by scholarship. So…..graduate medical school, train civilian residency, and at the end of the training, the military gets you as a specialist for the four years of medical school support.
Set me straight on this please.
It’s only fairly recently where physicians could finish training without having to consider there would be a draft notice in the mail. The docs of those days said they could either sign up and have a decent chance of getting an assignment they wanted, or take their chances with the draft and maybe getting a particularly undesirable posting.
Since people can and do practice with only an internship on civilians–at least in my state, I see no problem with general medical officers doing so, especially given that the population is prescreened.
BTW, it seems to me that the real factor is, do you want to serve the military. If you do, then the scholarship is a great deal because you get your med school paid for and get to do what you want to do.
If you are adverse to service life, then it isn’t so hot, and loans might be better. For me it came down to that–do I want a miliatry career or not. I decided that I don’t like oganizational life that much and love my freedom too much. While the service people pay for freedom for all of us by putting their lives at risk, I paid for my personal freedom by borrowing money and sneaking in some forbidden moonlighting jobs.
“Set me straight on this please.”
No, military medical students cannot decide to go the civilian route if they fail to match. The 75% stat covers all applicants. If you fail to get selected for a specialty, you become a general medical officer.
Continuing on my question, halfMD or anyone else who knows the system.
Then what happens, I guess, is you do several years as a GMO, and then you are free to pursue a civilian residency, do I understand this?
In my civilian residency, there were several physicians who did exactly that. They did their GMO service, got to diagnose rare and unusual tropical diseases in various locations in the world, finished their service, then went on to civilian residency.
They were some of the best residents. Seasoned clinicians, certainly better then me. One diagnosed one of those tropical diseases on an attending physician from the same part of the world. Better than our own infectious disease doctors could do.
I thought……but I didn’t do military…..that if you did a military scholarship and you did a military residency, your term of service was longer. Med school payback AND residency payback. So you served those years one way or another, either as a GMO or as a specialist.
Do i understand that right?
In know at one time, the D.O.’s wanted those military residencies because the training was recognized by both sides, and M.D. residencies were more closed to D.O.’s.
Although I’m not foolish enough to think that’s gone, I’d think it’s less of an issue now than in years past.
I was an HPSP scholarship student. I am so thankful that I did NOT get into my first residency choice and instead did 3 years of GMO time in the Air Force.
It gave me personal time, an opportunity to moonlight, and ended up changing my specialty choice (EM). Going back to residency was fun and easy. I “appreciated” learning again. I was not in debt.
For those like me that waffled between specialties it worked out perfectly. It is quite unrealistic to choose a lifetime specialty based upon the exposure of 2-4wk rotations as a third year medical student.
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