[Editor's note: This is a guest post from long-time blog reader and frequent commenter Beau Ellenbecker, Do, a private do family practitioner who spent a few years in the Ground forces after accepting an HPSP scholarship to pay for medical school. Similar to me, he has mixed feelings about his decision. In 2007, he wrote an HPSP guide for a student doctor website. He sent me his recent revisions which I thought were worth publishing as a guest post. Those considering this scholarship would exist wise to read this prior to making a decision. Beau and I have no financial human relationship. I've interspersed a few clearly-marked comments, mostly by mode of clarification throughout his mail service.]

In 2003 I accustomed a 3 year HPSP scholarship in the Ground forces.  I completed the last three years of medical school under scholarship, then moved to Hawaii for a iii year military residency, and finally finished my obligation with a 3.5 year consignment in Europe that included an 11 month tour of duty in Transitional islamic state of afghanistan.

My Feel With the HPSP Scholarship

1. The Pay

  • Signing bonus of $20,000 (variable based on needs of the miltiary)
  • Monthly stipend of $2100 a calendar month for 10 and ½ months per twelvemonth
  • 2nd Lieutenant pay of $2900 a month for one and ½ months per yr
  • Total pre-active duty pay: $126,000
  • All books, fees, and tuition to the medical school of your option in the U.s.a. or Puerto Rico
  • Adventure, jazz, props from the public, a nifty uniform, and the sense of pride with military service
  • Rank of 2nd Lieutenant while in school and promotion to Captain (Lieutenant in the Navy) upon graduation. Well-nigh military physicians are promoted to Major (Lt. Commander in the Navy) at vi years of agile duty (counting residency)

2. How Hard is it to Become HPSP Scholarship? What Are the Requirements?

Laissez passer Physical Fettle and weight standards regularly, be eligible to be commissioned as an officer in the military, enroll in an accredited medical school, utilise and be selected (automated credence for Army is 3.five GPA and 29 MCAT)

3. What is the Payback?

Dr. Ellenbecker enjoying his time in Afghanistan

Dr. Ellenbecker enjoying his time in Afghanistan

One year of service per twelvemonth of scholarship received. Military residencies do count as payback, however, you besides accrue ane yr of payback for each year of residency afterwards your FYGME (Internship) year. In other words you tin can complete one extra year of residency past your level of commitment without incurring more than time. (iv year scholarship recipients tin can practice 5 years of mail service-grad training without accruing more time). Also if you do a civilian residency you payback will not outset until y'all showtime on active duty. [Editor's Annotation: As a general dominion, you'll have the same payback whether y'all are chosen to do a armed services or a civilian residency.]

four. What Will I Make as a Physician in the Military?

These are new figures calculated every bit of 2014 for a 4 twelvemonth scholarship. I have factored in the cost of medical schoolhouse education, stipend, bonus, and interest to accomplish a scholarship value.

Scholarship Value

Medical School Education Loans Saved * 4 years: $160,000
Involvement Saved: $77,000 (Based on 10 years at 6.5%, postal service residency)
Pre-Residency Pay: $126,000

Total Scholarship Value (4 years): $363,000 (about 91K per twelvemonth of delivery)

[Editor'due south Note: I idea this was an interesting calculation. The value of the "scholarship" to me was much closer to $100K given my very cheap medical school, the interest rates available upon my graduation in 2003, and the much lower pre-residency pay provided then. I'1000 not surprised to see it is more valuable now given rising tuition, college pupil loan interest rates, and the difficulty the military has had acquiring physicians given the loftier deployment ops tempo in the terminal decade.]

Military Pay (average stateside)

Pay: 46.8K (Captain)
BAH: 16K (housing assart, varies by location)
BAS: ii.5K (nutrient allowance)
VSP: 5K (specialty pay based on years)
BCP: 2.5K (board certification pay)
MASP: 15K (flat pay given to all doctors)
Isp: 20K (independent specialty pay based on specialty: Family Medicine)
Bennies:  30 days paid vacation and free wellness/dental/vision

Yearly Pay as a Practitioner: $108,000

Yearly Bounty as a Practitioner for 4 twelvemonth commitment: $199,000
(Military Pay + Scholarship Value/4 years)

Average Starting salary for a civilian FP: $145,000 [Not certain of source for this, but at to the lowest degree i easily constitute source suggests the figure was $170K in 2012. If anyone has current MGMA or other survey data for 2014 I'll supercede it here. Acquit in mind that this effigy may be much higher for your specialty, and even for your individual position- which may be far higher up boilerplate.-ed]

If you choose to stay in the military there are bonuses for resigning that significantly improve your pay however they require multi-yr commitments. Currently a four year commitment for a family unit doc signed Afterward your initial commitment is worth $30,000 annually. [Editor'south Notation: It should exist noted that these bonuses are highest when your initial commitment is up and quite a bit lower as you approach the magical 20 yr mark where you become eligible for a military retirement. The military has thought about all these incentives and uses them to "force-shape."]

Yearly Compensation every bit a Practitioner after signing a 4 year ADD ON post initial delivery: $165,000
Pay is pretty competitive for primary care, for specialists it is not even shut. A cardiologist in the Ground forces can look to make at about most $200k. In the civilian side its closer to $300K.

5. What Will I Make as a Resident?

Yearly Pay equally a Resident: $65-70,000 (No Isp, MASP, or BCP)

Average pay for civilian family medicine resident – $42-60,000

6. Where Will I do Residencies/Rotations?

Actually depends on which service [and specialty-ed] yous select. Even so, I strongly suggest that you practice a rotation in the specialty y'all want at your pinnacle location option. Near Navy and some Airforce candidates will be required to do GMO/Flying Surgeon tours afterward their internship (2-iii years) and before residency. You can gain valuable feel but personally, I hate this idea.  Information technology puts the least capable and least educated physicians in often isolated environments and makes them responsible for a majority of troop health.   The regular army really only does this if you lot switch specialties and there are no residency spots bachelor in the specialty you desire. [Instead, the regular army fills these slots with fully lath-certified doctors, similar a pediatrician working as a GMO/Battalion surgeon after finishing a 3-year peds residency.-ed] Of note, if you chose to get out after you lot serve extended time as a GMO (if your contract is up), it may be harder to get a civilian residency every bit you are so far removed from your internship and schooling.

Is the four-year obligation really but 4 years, or can a "stop-loss" social club keep you in much longer? When does my commitment really end?

A stop-loss order in a time of war could go on you in, nonetheless, it is highly unlikely given previous use.

7. Assuming a Four-Year Obligation Afterwards Residency, How Many Times Can They Make You Move (not counting a deployment, of course)?

1-2 times after residency, unless you are really unlucky. A stateside tour is ii-4 years. Overseas tours are 2 years if you don't take family and 3 years if you exercise.

viii. Since HPSP Students Are in the Reserves During Medical School, Can They Exist Called up Even Though They Have Non Completed Their Medical Education for Regular Reserve Duty?

No. Under no fashion tin can you be pulled out of school or your 1st year of residency.

10. State School, Individual School, or Daddy's Pocket?

You lot should not take the scholarship for the money. Yous volition regret it. You must accept a desire to serve in the military machine. The military is not for everyone. That being said, you will regret taking this scholarship if y'all are going to a medical school that costs less than 20K a year. The coin you will make early on in your career would easily offset such a cheap education loan.   Had I gotten into a state school I would not have taken the scholarship.

Dr. Ellenbecker enjoying his time as a civilian

Dr. Ellenbecker enjoying his time as a civilian

eleven. What About After Graduation?

The war machine requires that you lot apply for a armed forces internship year (FYGME). Nearly everyone will practise a military internship. Your FYGME will either exist in your field of pick (possibly fast-tracked into a residency) or washed as a traditional rotating internship year.  In about cases, if you don't match in your field of choice y'all can defer out and practise a noncombatant residency after completing your FYGME year withal you must exist accustomed to a civilian program in that specialty.

[Editor's Note: By manner of clarification, all med students with a military commitment must go through the armed forces match. This has two parts- first for specialty, and so for program. If you are not selected for your specialty, the military may put you into a armed services internship you take null interest in, such as a surgical internship, so assign y'all as a GMO. Once you are selected for your specialty, yous will either exist placed into a military machine program or y'all will exist allowed to become through the civilian match. You can rank these options in the order you prefer, but the process does non necessarily favor the bidder in the same manner equally the more objective, computerized civilian match. This process for your specialty is controlled by a handful of people sitting effectually a table. For the most office, they are good people who try to practise what is right and give you what you want, but they are express by the "needs of the military" and inevitably, some people (ordinarily the least competitive) practice not get what they desire. Information technology helps a not bad bargain to figure out who these people (your service's specialty leader and the residency program directors for your specialty and service) are and personally see, and impress, them.]

12. Retirement

Military retirement is 0% vested until xx years, after which it becomes fully vested at ½ base of operations salary. Most physicians that choose to stay till retirement volition be Lt. Colonels (Commanders for Navy). This means a yearly retirement pay of about $twoscore,000 (indexed to aggrandizement) plus lifetime healthcare benefits. In that location is, however, talk of modifying the retirement pay.  Retirement is pretty good if yous stay 20 years as you tin can still get another chore however you HAVE to finish 20 years to get anything. That to me is a big drawback.  The military besides offers the Federal TSP (like a 401(m)). There is no match, but the investment options are the cheapest you volition find anywhere.

thirteen. Why the Army?

Why did I select the Army? Several reasons actually. I have family history in the Army which fabricated me lean one way, but the Ground forces has a lot more than scholarships and residencies then the other branches also. I practical afterwards in the year and so my best shot was in the Army. The Navy had some drawbacks for me, mainly in the grade of the required GMO tour. The Navy and Air Force arguably take better residency and base locations.  I remember branch of service is more a personal pick than anything else. Even so, if I had the opportunity to make my selection once more I would probably cull the Air Force.

16. What Was My Career Like in Regular army Family Medicine?

I completed medical school in May of 2006 and five days subsequently moved to Hawaii to brainstorm my residency at Tripler Regular army Medical Eye. Hawaii isn't a bad place to practice a residency. I enjoyed my non-working time at that place and work was tolerable. Tripler is a major medical center and so as a family resident I was a little flake disadvantaged when information technology came to procedures and learning in some of the departments equally they tend to teach their own residents start. A medical center does ordinarily provide a nicer phone call schedule in 2nd and 3rd year than a hospital with merely family medicine residents would. Overall, my experience was similar well-nigh residencies. I would say on a whole that we probably had a smaller inpatient population then some civilian residencies yet we still saw quite a bit of pathology.  We also completed a lot more inpatient rotations and OB care than most civilian residencies.

Personally, I think armed services residencies lack a picayune in breadth given lower patient volumes but make up for it greatly in depth.  I can virtually immediately tell a military physician from a non-armed forces physician only past reading a few notes.  Armed services docs tend to write much better and more meaningful notes and tend to be much more cost-constructive than civilian docs.  Almost notes I read from civilian internists are and so poor in quality that I can't tell what has been washed to the patient or what their plan actually is.

Each specialty and co-operative treats your showtime consignment differently. For my specialty, we are interviewed about where we are from, where nosotros would like to go, and what is about of import to us (i.due east. location, clinic chore, infirmary job, unit based chore). My married woman and I were leaning towards leaving the military and felt that we would only get one shot at living overseas so I volunteered for Deutschland, still, I was insistent on going to clinic every bit I felt a unit task wouldn't provide the continued learning I felt I needed leaving residency. The interviewer then weeds through all the candidates and tries to match you as best as he can to a future assignment. Non everyone gets their top pick, but the guy actually does a pretty skilful job. If you are a good candidate (chief resident, high lath scores, former military) or know how to work the organisation y'all can sometimes aid the process along. In my instance, contacting the commander where I wanted to go and being chief resident helped me get the detail base in Deutschland I wanted.

Prior to going to Deutschland, I had to consummate OBLC (basic training) in San Antonio as I wasn't able to do and then between my 1st and 2nd year of medical school. They no longer offer waivers for this course. OBLC was a consummate waste of fourth dimension considering I had been in the ground forces for 3 years and almost of the data is geared toward medical platoon leaders, not doctors. If you lot have the opportunity (almost practise) to take the shorter course during medical school, you lot should.  Y'all volition larn the military machine finds interesting means to waste your time. Besides never, ever believe anything anyone tells you virtually your career. Become EVERYTHING in writing. I accept had several disappointments because I was misled by others along the way.

In Germany, I took over doing main care and procedures. Armed services medicine takes some getting used to but in one case yous become it downwards information technology can exist pretty enjoyable. About 6 months later on I arrived in Germany I got orders to deploy with a unit of measurement in Frg (2/two SCR) to Afghanistan. If possible they will have yous attend their three-4 calendar week train-up held in Germany, Louisiana, or California about three months prior to your deployment. As a doc, you lot are required to study to your unit (commonly not located at the same base as you) about a calendar month prior to your deployment and they can keep you for up to three months afterwards. Most units, however, release you inside 2 weeks.  Which means that your deployment is actually longer than the residue of your unit of measurement'south is.   Also, numerous physicians failed to receive payment for housing during the pre/postal service deployment periods which can be financially quite taxing.   If y'all are joining the Army yous can count on deploying for 9 months inside one year of graduation from residency. [Everything in this paragraph is Regular army-specific and your experience volition vary in the other services. One nice matter about deployment is pay. About of your pay (except bonuses) is tax-free while deployed and you receive several other pays like family unit separation pay ($250/mo), hazardous location pay ($100/mo), combat pay ($225/mo) and per diem ($iii.fifty/day). In all it means that while deployed y'all make about $1600 more than a month after taxes. [Of grade, if you were moonlighting prior to deployment, your pay may actually go down while deployed.-ed]

17. Would I Do information technology Once more?

That's a really hard decision to make. In that location are a lot of variables.

Get-go, there is the money. The scholarship is worth twice what it was when I joined (we had no bonus and were paid $1000 less a calendar month). The armed services will pay y'all at least $20,000 more than a year in residency than the noncombatant side which is a really nice feature [While the military machine still pays more, the departure is decreasing as residency pay has been climbing the last few years.-ed] However, they will pay y'all at least $35,000 less (as a family dr.) per yr and so you would make as a civilian.   That's over $120,000 in lost pay. All the same, yous add in the scholarship value and the extra pay in residency and you exercise come out significantly alee IF Y'all Practice PRIMARY CARE.

2d is lifestyle.  I would probable take never had the opportunity to live in Hawaii or Frg had I not joined.  I have visited a lot of Europe for very cheap due to living there.  The Army has great free healthcare and provides a lot of discounts on many things.  That being said, if you were unhappy with your task, your co-workers, or your lifestyle in the noncombatant side, you could pack up and movement.  That is not an option in the armed services.  I probable would not be happy with the lifestyle the army has provided me if I had washed my residency in Georgia (my last pick) and had my first consignment in Fort Polk (middle of nowhere Louisiana). You don't always accept a lot of control over this.

Dr. Ellenbecker enjoying his time NOT in Afghanistan

Dr. Ellenbecker enjoying his time NOT in Transitional islamic state of afghanistan

Third, yous should consider family.  For the most role, the Ground forces provides adequately well for families but that doesn't make information technology like shooting fish in a barrel.  It is very hard for spouses to discover jobs overseas or to uproot their job or educational objectives every few years.  For me, family is the most important matter.  My married woman and I had our first child shortly later on we arrived in Germany and I had to go out him for a twelvemonth when he was 8 months sometime.  That was really difficult.  We added a little girl to the family afterwards I left the Army and it only cemented in what I missed out on.  I have no desire to leave my wife and child again for this length of fourth dimension.   Deployments are long and difficult. Nosotros weathered the tempest but non everyone does.  Civilians get paid A LOT more to do the same job active duty does downwards range.  I was once asked what it would take to do another yr in Afghanistan and I said $500,000.  The Army isn't going to pay that.

Finally, think well-nigh what you lot want in a career.   Army medicine was for the near office enjoyable for me, merely it isn't for everyone.   Army politics and posturing is a constant boxing.  I have no uncertainty that I will enjoy my medical career more than outside the military machine and so I have inside the military simply due to non having to bargain with Regular army BS.  In addition and possibly most importantly, 1 needs to realize that you have ZERO control over your career until you make Lt. Col.  I had a very adept friend who upon graduation was stationed at Fort Drum (a horrid location).  For 4 months he worked 5 days a week in a clinic setting and a 12 60 minutes (day or night) every other weekend in urgent care.  He was not paid more for the extra hours and he was not compensated with off time.  He was and so promptly deployed to a forward outpost where he essentially provided sick call to about 60 soldiers for a year.  Not exactly a good fashion to outset ane'south career (skill erosion).  Upon return from deployment, he was assigned to an admin position and did patient intendance about 1 mean solar day a week for the next xviii months despite request to move repeatedly.  The army had no interest in him maintaining his skills.  It's deplorable too, every bit had he had a better early career he probably would have stayed in the war machine.

Would I practise it all again?  I don't know.  For today's offering probably.  Given the offer I had, probably not.  The bonus would accept helped a lot and my stipend was so low I had to take additional loans just to make rent which I wouldn't have had to do now.  I enjoyed my fourth dimension, but I am happy to be out also.

What do y'all call back? Did you accept the HPSP Scholarship? Were y'all glad or were you disappointed? Would you lot do it once more? Did you consider it and turn it downwards? Why or why not? Comment beneath!