Medical

Pathways to a Military Paycheck in Medicine

The first step in securing a military paycheck in medicine is making absolutely sure the military is right for you. Growing up in a military family, I know firsthand the sacrifices involved. Surrendering control of where you live and how long you can stay in any given place is a very serious decision. If you haven’t had the privilege of knowing people in the military, make a point to meet people (IRL or on the forums), ask questions and thoroughly research military life and current trends in military medicine before joining. Much like a Medical Scientist Training Program is not a good deal unless you want to do research, a military scholarship is a terrible idea for people who do not genuinely want to join the military. 

For someone who feels called to serve our country as a member of this institution, there are several excellent ways to align your military career aspirations and medical training.

Health Professionals Scholarship Program (HPSP)

HPSP is an umbrella program that encompasses Army, Navy and Air Force scholarship programs (note, there are no physicians in the Marines). Despite running similar programs, these services are very different. You should carefully investigate which branch of the military you would like to join before applying. 

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HPSP requires years of service equal to the years a scholarship is given, with a three-year minimum. If you receive a scholarship at the start of medical school, you can expect to serve in the armed forces for four years after residency. 

Residency and the Match

Of note, HPSP recipients may be pulled after intern year to work as General Medical Officers before completing residency. The Air Force and Navy have interesting GMO possibilities working as a Flight Surgeon or Diving Medical Officer. According to Army Recruiter Sito Moise, the Army recruits HPSP recruits at a 1:1 ratio to available residencies and offer a 98% direct-to-residency rate. Students with special interests or a strong desire to complete residency immediately after medical school should take these differences into account. 

HPSP also requires applicants to participate in the military match. Many applicants are placed during this match cycle and are not able to choose civilian residencies. Placements depend on the needs of the military and not an applicant’s preferences. Residency slots available for a given specialty are also based on military needs. The military does attempt to honor specialty desires and are open to placing recruits into a transitional internship, allowing them an extra year to match to their residency of choice. If you’re set on a competitive specialty outside of primary care, however, HPSP might not be the best option. Residency years do not count toward service commitment, but they do count towards military retirement. 

HPSP Benefits

The benefits of HPSP include full tuition and a stipend for living expenses during medical school. A signing bonus of $20,000 is also available when making a four-year commitment. The stipend is generous at over $2000 monthly and the perk of graduating without loans is nothing to scoff at, but military physicians make significantly less than their civilian counterparts. Unless you’re planning a career in primary care, the result of an HPSP scholarship is a more equitable standard of living across your medical school training and early career, not necessarily more money in your pocket overall. 

The financial specifics depend on the cost of your medical school and specialty choice. The White Coat Investor has an excellent post where he looks at rough figures. 

Health Services Collegiate Program (HSCP)

HSCP is a little-known military scholarship alternative to HPSP. It is ideal for students who are attending a less expensive medical school, interested in joining the Navy, and open to working as a General Medical Officer before starting residency. It is a particularly good program for people intending a military career because your four years in medical school count towards retirement. 

Enrollees pay their own medical school tuition but receive a paycheck from the Navy while in school. Pay is just over $4000/month when accounting for salary and a housing allowance. It also includes medical. 

The Financial Assistance Program (FAP)

FAP is a military medicine option for residents. The main perk here is that participants have already matched to a civilian residency of their choice. They will enter their service years after residency instead of possibly serving as a GMO after intern year. Also, FAP allows young would-be military physicians to make the choice after medical school. 

Benefits include an annual grant of $45,000 and a monthly stipend of over $2000. Enrollees commit to two service years for their first FAP year, and then one service year for each additional FAP year. A four-year FAP enrollment thus translates to five years of service. 

Active Duty Health Professions Loan Repayment Program

Physicians who join the military after completing residency are eligible for up to $120,000 in loan reimbursement paid in $40,000 installments over the first three years of service. 

Military Medicine in the Reserves

Not keen on a military career, but open to the possibility of deployment in times of need? Keep in mind that deployments may require you to leave dependents behind. You can be deployed more than once. You can be deployed to a war zone. Joining the reserves with the hope that your number will not be called is a potentially disastrous gamble. 

There are a couple options available including the Medical/Dental School Stipend Program (MDSSP), Specialized Training Assistance Program (STRAP), Training in Medical Specialties (TMS), and Health Professional Loans Repayment Program (HRLRP). In any of these programs you can expect a monthly stipend of about $2000. Enrollees commit to one service year in the reserves or national guard for each six months of stipend received.

If you’re open to a seven-year commitment to the National Guard, the Health Care Professional Loan Repayment Program (HCPLRP) offers up to $250,000 in loan reimbursement for this commitment. This program can be completed at the same time as STRAP provided you have finished two years of residency. 

Physicians who join the reserves after completing residency are eligible for up to $50,000 in loan reimbursement paid over the first three years of service. 

United States Uniformed Services University of the Health Sciences

A unique option for aspiring medical students who are interested in serving with the military is the F. Edward Hebert School of Medicine, a branch of the Uniformed Services University of the Health Sciences (USUHS). Tuition is waived and students receive full pay and benefits as a junior officer (O-1). Students can expect just over $3000/month and a housing allowance. The four years spent in medical school do not count towards paygrade or retirement. USUHS medical students commit to seven years of active duty service. Residency does not count toward this requirement. Given the relatively long service requirement, this option is a good fit for people who are planning a long-term career in the military. For more information the military has put together a comprehensive guide.

Conclusion

The below table details the benefits and requirements of different military scholarship and loan repayment options:

  Medical School Tuition Monetary Benefits in Medical School Residency  Service Requirements
HPSP Yes ~$2000/month+ $20,000 signing bonus Military Match – specialty limitations Four years (if beginning MS1)
HSCP No ~$4000/month+ Medical school years count toward retirement Military Match – specialty limitations Four years (if beginning MS1)
FAP No None Civilian residency with a Military grant ($45,000 annually) and stipend ($2000/month) Two years for the first FAP year, 1:1 ratio after the first year. 
Active Duty Repayment $120,000 in loan reimbursement  None Civilian residency  Loan paid in $40,000 installments over first three years of service 
Reserves No ~$2000/month, though programs vary  Civilian residency  One year of service for each six months of aid
USHUSYes (free)$3000/monthMilitary Match – specialty limitationsSeven years

This bottom line is that HPSP, though the most well-known military medicine option, is not the only way to become a military doctor while taking advantage of education-related financial benefits. In fact, it is the most limiting option since scholars will likely need to complete a military residency and might find residency delayed altogether. Before selecting a path, be sure to weight the pros and cons of each option carefully. 

Updated November 4, 2019 to add information on USHUS.

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Any reason why USUHS was omitted from the article?
    Good call! I should have included that as well. It wasn't as clearly on my radar since it requires admission to one specific medical school, but it is a great option!
    We've updated the article to include information on USHUS.
Overall a good summary article, but those who are interested will need to do their own research not only to see if miliatary healthcare is right for them, but also if they meet the requirements. All of these programs have limitations on the physicial abilities and health of applicants; those applicants who have physicial limitations that would otherwise NOT limit them from attending "regular" medical school, would be denied acceptance to these programs. Furthermore, some of these programs have age limits, which effectively locks out older premeds from applying because they would not be able to finish their medical training before the age cut-off goes into effect.
Writing this article without mention of USUHS is the equivalent to you writing an article about the path to becoming a military officer without mentioning the service academies.
For USUHS, the 4 years do count for retirement if you stay in for 20 years. (I.e. 20 goes straight to 24). I suppose you mention housing allowance but take home after taxes is actually around 5k/month, not including TSP matching and paid travel/per diem.
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