Question on HPSP

[jasminric]

I just took my MCAT, and I am applying this cycle. Currently, I am looking into HPSP, and it sounds like a good deal to me. I mean, you go to med school for free, plus you get free training (which looks good on your resume). I don’t mind doing all the physical stuff, and I understand that I’d get paid less than civilian doctors, but that won’t make a difference 5 years down the road; all doctors get paid a lot anyway. Anyway, this sounds like a good deal to me. Let me know if I am missing something important because Reddit is against it if you're doing it for the money for some reason.

Unrelated question:
Let's say I want to be a general surgeon, and I attend med school for 4 years. I know I have to pay them back for the years attended. Will my residency time count toward that?

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[SirGecko]

It sounds like you don’t have a firm grasp on what joining the medical corps entails. There are a lot of threads on this forum that will expand on this but a few things:

1. HPSP is not free. You are trading years of your life for the money. Could still be worth it depending on your personal situation but it’s not free money.

2. “ Won’t make a difference 5 years down the road”. You would probably benefit from doing the numbers on that one before making statements like that. The pay difference is substantial for several specialties and a delay of several years can do a lot to your finances. That time value of money is also one of the ways you benefit from HPSP since you are paid higher in training but you have to invest appropriately to take advantage of it.

3. Payback: lots of info about that in this forum. Residency adds payback but it’s concurrent with HPSP. If you did HPSP and gen surg and went straight through you would owe four years after residency.

 

[pgg]

Welcome!

You have a lot of reading to do on this forum.

There's a lot I could say here, but I'll stay brief for now.


There are a number of sacrifices associated with being a doctor in the military. Pay is not the most significant one. You're not just a doctor who works in a hospital with Army or Navy or Air Force in the title, with a guarded fence around it. There are deployments to dangerous places, time away from family, loss of choice concerning where you live and when/where you can travel. Most important and probably hardest for a pre-med person to appreciate, there are limitations to how and where you can practice medicine. There are many threads here about the concerning case load and variety at many military hospitals.

(Also ... please don't fall into the common pre-med trap of telling people you don't care if you make much money as a doctor, because all doctors make a "lot" of money. Some people say this sincerely, others are playing some weird virtue signaling game. Either way - you currently have only the barest hint of an idea of how much pain, suffering, and sacrifice you're going to slog through in medical school and residency. You'll either owe money via loans, or time via HPSP, when you're done. You'll be 15 years behind your college grad peers in starting to actually earn money and saving for retirement. You'll deserve every penny of that "lot" of money, and more. Don't be so eager to express willingness to trade away income you haven't earned yet.)


To answer your question, obligated service calculations can be complicated. Time spent in residency training does count toward repayment of HPSP years. However, it incurs a new 1:1 obligation. Effectively, when you're done with residency, you owe a number of years equal to the longer of the HPSP scholarship or the residency. Internship is a neutral year. So if you do a 1+4 year general surgery residency you'd end up owing 4 years of service when you were done.

 

[Helpful Troll]

Most, if not all Army general surgery residency programs are 6 years now with a research year built in. So the adso after residency is likely 5 years with the neutral intern year.

 

[HighPriest]

“Free”

It was the most costly investment I’ve ever made.

 

[comp1]

There are many, many ways to get med school paid for both before and after graduation. To start with, the VA has its own HPSP now in addition to EDRP if you didn't want to commit just yet. If you're not into the VA for some reason, there's PSLF which is now starting to pay off and has a lot of additional options. You join the military because you want to join the military. The finances of such a choice might be a good "deal" for enlisted personnel, but it does not in any way work out positively for physician officers. It isn't supposed to, there are too many other options. You're paying to serve; it's first and foremost a sacrifice. Regarding your "resume," outside of the VA (which has mandated veteran preference), military service is going to be a net neutral or more likely just irrelevant. Most civilian medical employers understand the limitations of military training/medical practice.

 

[pgg]

I think HSCP is probably the last remaining option that may be a good financial deal, for a select group of people with prior enlisted service.

HPSP and USUHS should be viewed as financial losses compared to loans. That doesn't mean no one should do HPSP or USUHS - but the old advice of not doing it for the money applies more than ever now.

 

[Baron Samedi]

“Free”

It was the most costly investment I’ve ever made.

There's a reason everyone congratulates you on your way out and not on the way in. I felt like a prisoner released for good behavior getting high fives from all the guards during my out-processing.

 

[militaryPHYS]

I think HSCP is probably the last remaining option that may be a good financial deal, for a select group of people with prior enlisted service.

HPSP and USUHS should be viewed as financial losses compared to loans. That doesn't mean no one should do HPSP or USUHS - but the old advice of not doing it for the money applies more than ever now.

Ah I still disagree on this. Money is useless if you don’t have the lifestyle and perspective to be able to use it wisely. USUHS is an incredible opportunity for early tax-protected wealth building if done correctly by maxing out your TSP starting first year of med school. It also teaches you how to live without debt and within your means.

If you end up landing a working spouse (or better yet a USUHS spouse) you can even afford to live very comfortably and spend on once in a lifetime overseas travel opportunities and experiences while still maxing out retirement accounts and contributing to taxable. All is doable because of the tax breaks and other non-salary benefits (post 9/11 for kid, less on life insurance and disability insurance, childcare supplementation from MCCYNH, VA loan, etc.).

Sure, if you look dollar for dollar at salary for a specialist they may earn more over the course of 13 years (time for med school, 4 or 5 year residency and then 4 years payback) but that doesn’t tell the whole story. Lifestyles are way different, tax protected growth was accumulating for 9 years for the USUHS student yet civ is doing most of contributions during last 4 years once finally staff yet still also has loans to pay off, fund a 529, etc. For primary care I’ve run the calculations and they are even between military and civilian for average salaries.

Anyway, still not a reason to do USUHS, but for those who end up wanting to do it anyway, financially you can really get a huge jumpstart and live really well during that time. My point is financials for USUHS, HSCP and even HPSP aren’t cut and dry in the negative column if you’re a blue collar, live within your means, super saver type person.

 

[armytrainingsir]

Ah I still disagree on this. Money is useless if you don’t have the lifestyle and perspective to be able to use it wisely. USUHS is an incredible opportunity for early tax-protected wealth building if done correctly by maxing out your TSP starting first year of med school. It also teaches you how to live without debt and within your means.

If you end up landing a working spouse (or better yet a USUHS spouse) you can even afford to live very comfortably and spend on once in a lifetime overseas travel opportunities and experiences while still maxing out retirement accounts and contributing to taxable. All is doable because of the tax breaks and other non-salary benefits (post 9/11 for kid, less on life insurance and disability insurance, childcare supplementation from MCCYNH, VA loan, etc.).

Sure, if you look dollar for dollar at salary for a specialist they may earn more over the course of 13 years (time for med school, 4 or 5 year residency and then 4 years payback) but that doesn’t tell the whole story. Lifestyles are way different, tax protected growth was accumulating for 9 years for the USUHS student yet civ is doing most of contributions during last 4 years once finally staff yet still also has loans to pay off, fund a 529, etc. For primary care I’ve run the calculations and they are even between military and civilian for average salaries.

Anyway, still not a reason to do USUHS, but for those who end up wanting to do it anyway, financially you can really get a huge jumpstart and live really well during that time. My point is financials for USUHS, HSCP and even HPSP aren’t cut and dry in the negative column if you’re a blue collar, live within your means, super saver type person.

I would agree that for primary care, it still might be a good deal.

And probably the best deal going for folks that end up hating clinical medicine and thrive on meetings and policy and whose hobby is running.


What your spouse does is really irrelevant to the immediate discussion. Marrying a neurosurgeon is gonna bolster any family’s finances, same as marrying an heiress would.

 

[Baron Samedi]

I know people who did USU/HPSP who are in financial ruin and those who are civilian primary care docs who have well-eclipsed my own savings. The ability to save, invest, and manage debt is an individual merit and not related to mil vs civ.

 

[militaryPHYS]

I know people who did USU/HPSP who are in financial ruin and those who are civilian primary care docs who have well-eclipsed my own savings. The ability to save, invest, and manage debt is an individual merit and not related to mil vs civ.

Truth!

Oh I forget to talk about all the tax protected money you can save while you’re stuck deployed for 6-12 months not practicing your specialty! 🤪

 

[DrMetal]

I know people who did USU/HPSP who are in financial ruin

That's b/c they're stupid. Doctors tend to be very stupid people, look how we learn.

A long time ago, I made it a rule to avoid 5-figure hobbies (cars, boats, etc). Keep your hobbies in the 4-figure range (golf, guitar, skiing, etc).

 

[HighPriest]

Yeah, it may be a good idea for primary care.

I don’t think you need to sign away 10+ years of your life to learn how to save money appropriately. You can do that without the military.

I haven’t done the math, but it is possible that my employer contributions to my retirement fund have already eclipsed the compounding interest I made in the military with tsp.

I can say with certainty that I do much better on interest now that I’m not subjected to the limitations of TSP.

Of course I never deployed, but if we want to talk about quality of life and competency:

My quality of life is far better now, and that’s considering I didn’t deploy. If I had, triple that figure. Plus I go to work every day not wondering if I still know how to do the procedure I’m about to do.

 

[pgg]

Maxing out TSP in the military means about $20K per year. The lack of a significant employer contribution is a killer.

Maxing it out in civilian-land more than triples that.


I will happily concede that USUHS permitted me to live a lifestyle and comfortably have kids earlier in life than I would have otherwise. There's something to be said for higher pay during training at the expense of later income. But in the very long run, it was a loss - and I milked the Navy for every benefit I could (TSP maxed wile deployed, SDP, GI Bill transfered to my kid at a $50K+/yr tuition yellow ribbon private university, a FTOS fellowship exploiting the concurrent payback loophole, and now and for decades to come I'll collect a ~$70K/yr COLA'd pension).

I did all right in the end, but financially it was a loss. Money is not a good reason to join.

 

[Apollyon]

I milked the Navy for every benefit I could

And the image that immediately came to mind was milking a cobra for venom. Every edge is sharp on a cobra, like a bowling ball.