Note: The views expressed in this chapter are those of the author(s) and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government.
Special Thanks to Drs. Jami Peterson and Brett Chamberlin for their revisions of this chapter.
The military has two programs that provide financial support for medical students and one that supports residents. The Health Professions Scholarship Program (HPSP) and Health Services Collegiate Program (HSCP) are used to attend a civilian medical school. The Family Assistance Program (FAP) provides financial assistance to current residents. Each program provides various benefits in return for a contract serve as an active duty physician following completion of medical school or residency. Additionally, students accepted to the military’s medical school, the Uniformed Services University (USU) can earn their medical degree while serving on active duty. Alternatively, board certified physicians can apply to be a Direct Commission Officer (DCO) and begin service immediately upon commissioning.
Uniformed Services University (USU)
Established in 1972, USU trains future physicians in the unique aspects of military medicine while meeting all requirements for general medical licensure in the United States. Application to USU is through the American Medical College Application Service (AMCAS). In addition, applicants must also meet all requirements for active military service, including a medical screening examination and background security investigation prior to being unconditionally accepted into USU. Detailed information is available at https://www.usuhs.edu.
Each of the four uniformed services is represented at USU – Army, Navy, Air Force, and Public Health Service (PHS). While attending USU, Navy students are commissioned on active duty as an Ensign and receive military pay for that rank. All tuition, fees, medical supplies, and books are provided.
In addition to meeting all the requirements for medical education, a USU student is exposed to both life in the military and military medicine. Classes are given in military medical history, chemical and biological warfare, wound ballistics, deployment medicine, as well as many other military topics. At least two field exercises are conducted over the 4-year curriculum, giving the student a concentrated and intense introduction to medical support during simulated combat operations.
Following graduation, the new Navy physician is obligated to serve in the Navy for seven years in a non-training status following completion of the PGY1 (internship) year. Any commitment previously incurred through either the Reserve Officer Training Corps (ROTC) or any of the military academies is added to this obligated service and served consecutively.
Health Professions Scholarship Program (HPSP)
As a recipient of a HPSP scholarship, the military pays full tuition, all fees, reimbursement for required books and equipment, and a stipend of approximately $2300 per month. Participants get 45 days of active duty for training each year and are paid full entry-level officer pay and allowances during that time. At the present time, a signing bonus of $20,000 is offered. Time in the program does not count for retirement or pay purposes.
In exchange for financing the participant’s medical school education, an obligation to serve on active duty for the number of years of scholarship benefit or a minimum of three years (whichever is greater) is generated. HPSP eligibility requires that the applicant be a U.S. citizen (dual citizenship is not permitted), physically qualified for a commission in the military, and accepted into an accredited school in the U.S. or Puerto Rico. The minimum undergraduate GPA required is 3.2 and the minimum MCAT score is 500. Applicants must not have reached the age of 42 at the time of commissioning on active duty. Here is a link to the Navy HPSP website.
Periods in which officers are in a training status (such as internship, residency, or fellowship) do not count towards fulfillment of the military contract but count towards military retirement.
Health Services Collegiate Program (HSCP)
HSCP is very similar to HPSP, but with a different benefits package. Rather than commissioning into the Inactive Ready Reserve (IRR), students receive pay and benefits (including health insurance, basic allowance for housing, etc.). Medical school tuition is not reimbursed, however the time spent in HSCP does count towards the 20-year requirement for retirement eligibility. This pathway is most often used by prior enlisted students with families who attend a relatively inexpensive medical school, although having previously served is not a program requirement.
Family Assistance Program (FAP)
FAP is similar in concept to HPSP, with the exception that it applies to residency. Individuals can apply once they have been accepted to an accredited US residency program. The only caveat is that the types of residencies for which scholarships are offered may vary. Not all residencies and specialties will have a recruiting goal, so it is possible that the Navy does not offer the FAP scholarship to applicants in certain specialties.
Officer Preparedness Training
All medical officers attend 4 to 6 weeks of “Officer Development School” (ODS) located in Newport, Rhode Island. For USU students, this occurs prior to the first year of medical school. For HPSP students, this can occur at any time prior to graduation or immediately upon graduation. These courses are designed to give the new medical officer an orientation to military life as well as military customs and courtesies.
Graduate Medical Education
The typical pathways to residency training in the military are inservice programs at military treatment facilities (MTFs) or deferment and outservice programs that are completed at civilian residency training programs. For any given specialty, a graduate medical selection board is convened either in late November or early December to determine the program selection and the number of years of training for every applicant. Selection board results are published in mid-December.
Inservice Residency Training Programs at Military Treatment Facilities
Various Army, Navy, and Air Force MTFs around the country sponsor inservice residency training programs. They are all fully accredited by the Accreditation Council for Graduate Medical Education (ACGME). While in a dedicated post-graduate training program (internship, residency, or fellowship), payback towards the initial service obligation is on “hold.” The service commitment resumes upon graduation from training. Inservice training counts toward retirement, but generally incurs additional obligated service time that may be served concurrently with medical school and undergraduate educational obligations.
Navy Active Duty Delay for Specialist (NADDS) Programs for Residency Training Programs in Civilian Institutions
Some graduating medical students are selected for deferment for their entire residency, called the Navy Active Duty Delay for Specialist (NADDS) program. This means that the student can match as a civilian intern/resident and complete his/her training in a civilian program. Upon such completion, he/she then enters or returns to military service as a civilian residency-trained physician. In some cases, a similar deferment of service obligation is permitted for Medical Corps officers who are already in the process of completing or have completed an internship, called Release from Active Duty to NADDS or “RAD to NADDS.”
Other graduating students are, however, granted only a one-year deferment to complete an internship in a civilian program. They are then expected to serve in general medical practice as General Medical Officers (GMOs), Flight Surgeons, or Undersea/Diving Medical Officers (UMOs/DMOs) for 1-3 years before applying for further in-service, out-service, or deferred training. Once completing this tour, they can apply for residency training through the military or finish their military obligation in this role and separate from the Navy.
Application to this program follows the normal civilian “match” guidelines after approval from the Navy. Using the NADDS route to post-graduate training incurs no further obligation but it does not count toward payback for the initial obligation. USU students are now eligible for deferment training programs.
Full-Time Outservice (FTOS) Programs for Residency Training at Civilian Programs
Full-time outservice (FTOS) training allows Medical Corps officers already on active duty the opportunity to train at a civilian institution while remaining on full-time active duty status. Unlike members in a deferment program, FTOS trainees continue to draw their military pay. In addition, like inservice training, time served in FTOS training counts toward retirement.
The number of FTOS training slots awarded each year varies depending on the particular need for residency or fellowship trained specialists. Graduating medical students are generally not eligible for FTOS training.
Summary of Graduate Medical Education Options
As detailed above, there are many different options available for GME. The following chart summarizes the programs available to the different programs:
RAD to NADDS
|Eligible but rare||Not eligible||
Eligible but rare
Unique Opportunities in Military Medicine
The military offers unique opportunities not normally available in civilian medical practice and training. There is the opportunity to practice medicine in a variety of geographic locations spanning the globe. Military physicians can readily take part in both combat and humanitarian medical missions. In addition, the military offers unique training for physicians in undersea/hyperbaric, flight, tactical and wilderness medicine and other non-traditional fields. The practice environment is vastly different from civilian medicine, with near universal healthcare coverage of the patients you treat as well as significant protections of the individual physician from malpractice and litigation. Finally, there is a significant financial benefit and security to be gained from a military retirement pension with an automatic annual cost-of-living adjustment.
In order to assist the Navy’s Medical Corps recruiting mission, Commanding Officers have been encouraged to authorize permissive TAD to Medical Corps Officers who engage in recruiting activity.
In other words… if you were planning on taking leave, but spend some of your time helping to recruit for the Uniformed Services University (USU) or Medical Corps Health Professions Scholarship Program (HPSP), you can apply for no-cost TAD and not have to burn your leave. This is a great opportunity for young medical officers to network and build their leave bank.
- Make contact with your alma mater, Medical Officer recruiter, or any optimal group that may be interested in HPSP or USU. Email MedicalVIP.fct < at > navy < dot > mil for assistance. Feel free to email LCDR Brett Chamberlin (e-mail address is in the global) if you encounter any difficulties.
- Develop a plan to recruit, discuss, or generally represent Navy Medicine.
- Request Permissive TAD through your command.
Below are some upcoming USU recruiting events (HPSP recruiting welcome as well). Please contact margeaux.auslander.ctr < at > usuhs < dot > edu
|Dates||USU Event Name||Location|
|9/25/2019||Middle Tennessee State University Career Fair||Murfreesboro, TN|
|9/25/2019||Rhodes College Graduate School Expo||Memphis, TN|
|9/26/2019||Christian Brothers University Graduate School Expo||Memphis, TN|
|9/26/2019||University of Memphis Graduate School Information Fair||Memphis, TN|
|10/1/2019||Xavier University visit||New Orleans, LA|
|10/2/2019||LSU Health Professions Fair||Baton Rouge, LA|
|10/15/2019||UT Knoxville Health Professions Fair||Knoxville, TN|
|10/16/2019||UIUC Graduate and Professional School Fair||Champaign, IL|
|10/16/2019||East Tennessee State University Health Professions Recruitment Fair||Johnson City, TN|
Are you or do you know someone who might be interested in becoming a Military Medicine Ambassador?
The Uniformed Services University has recently established a Military Medicine Ambassador (MMA) Program. The mission of this program is to make known and communicate the opportunities available to practice medicine as a uniformed physician trained through the Health Professions Scholarship Program or the Uniformed Services University.
Military Medicine Ambassadors (MMAs) are “field” representatives of military medicine who provide information to interested pre-medical students and medical school applicants about medical school officer accession programs and the Uniformed Services University. MMAs will have the opportunity to visit their alma maters and/or universities near their hometowns, duty stations, or current medical practices.
Although many MMAs will be HPSP graduates, USU alumni, active duty service members, retirees, or separated service members; prior military service is not a requirement or pre-requisite for assignment. Anyone who has a sincere interest in military medicine, to include pre-medical and medical students, may be enrolled within this program.
One of the goals of this program is for MMAs to develop relationships with pre-medical programs, pre-health advisors, military recruiters, and interested applicants by sharing their personal experiences and knowledge about life as a uniformed physician. Volunteers will be able to participate as their schedules permit, and they will be provided with all the information and training necessary to participate in these activities. MMAs will also be able to utilize this work for their professional resume or curriculum vitae in support of academic promotions at USU.
If you are interested in learning more about this program, you can register at the following link: https://www.surveymonkey.com/r/K9LZ6JY or contact Commander Robert Liotta directly, whose contact info is in this flyer about the program.
In the recently released Winter Medical Corps Newsletter, I noticed this paragraph in the “Readiness in the Reserves” article:
I have just returned from PERS-9 (Reserves), reviewing important administrative processes. Here is the gouge…
HPSP Credit: Jeanitta Edwards verifies that the member was a HPSP participant and that the member is in a critical wartime skill (defined by DOD each year). Once she verifies this information, she sends it to another individual to load in the points for the year as credit towards retirement. The instruction requires a full year of service to receive credit for 1 year and caps the credit at 4 years. Unfortunately, because many medical schools start in July and graduate in May, the 4th year does not qualify. Some may have earned other points that year which can carry over for credit towards a good year. The 15 gratuity points are allocated on a pro rata basis so you will only get half those points for a half a year of participation. We will post the guiding documents to the Medical Corps Homepage. Please note that the actual HPSP policy is currently being rewritten.
A reader asked, “What are the official critical wartime specialties?”
Here is the portion of the document that lists them:
So what do those mysterious codes mean? They are defined in the Promo Prep, but since I’m such a nice guy here is the translation. The CWS include:
- General Surgery (15C)
- Neurosurgery (15D)
- Orthopedics (15H)
- Radiology (16Y)
- Anesthesia (15B)
- Internal Medicine Subspecialties (16R1)
- Emergency Medicine (16P)
- Flight Surgery (15A)
- OB/GYN (15E)
- GMO (15F)
- Family Medicine (16Q)
- General Internal Medicine (16R)
- UMO (16U)
- Psychiatry (16X)
Update just prior to publication – My wife (a Reservist) was sent this chart in the Health Professions Officer Special and Incentive Pay Plan, and the specialties under “USNR” match the list above:
If you are in one of these specialties, you can get retirement credit for your time in HPSP (or at least 3 years of the 4). In addition to the info above, here is what else I could find about this program:
We’re all starting to get pinged about the mandatory Blended Retirement System (BRS) training. While I’ve created a BRS resource center on the other blog I write for, the specific case of how BRS works for medical students was recently run to ground by Dr. Jami Peterson, the Head of Student Programs at BUMED. Straight from her, the BLUF is:
Any HPSP student who signed their contract BEFORE 01 JAN 2018 will have thirty days after signing into their FIRST active duty station to declare if they want to do the legacy retirement system OR the blended retirement system. For any students who start AFTER 01 JAN 2018 will automatically be placed in the blended retirement.
I’m also going to start providing an end-of-the-month summary of the personal finance articles I’ve written. Here they are: