1) While fellowships are generally not allowed after completion of one's mandated primary care residency, I remember from a previous post of yours that a child psychiatry fellowship might be an exception. Any thoughts on the feasibility of this?
Doing such a fellowship would definitely be possible. The NHSC would have to approve it on a case-by-case basis, though. It probably depends on the year that you apply for a fellowship, in terms of how many they think that their system can support, how badly they need psychiatrists RIGHT NOW, etc.
2) As a scholar yourself, have you found the NHSC to be well-managed and responsive to your needs and concerns regarding the scholarship and your eventual payback?
Well...not really.
I had an issue regarding my stipend. When I called the NHSC the first time, I got one answer. When I called them a second time, I got an entirely different answer. They then told me to call my regional supervisor
confused
who was never in the office. Eventually, after several voicemails, she emailed me and told me to call someone else. When I did call, the person that I talked to had no idea of what I was talking about.
<shrug> It's a government organization, so it's about as organized and efficient as one would expect. In order to get things done, you really have to be persistent and refuse to take "no" for an answer - both while you are a scholar and while you are looking for placement. Even then, it might not be enough.
3) One can't help but hear the oft-quoted "all NHSC scholars end up on a rig in the Aleutians or at a prison." How much difficulty do you anticipate finding a location that, while still serving a needy population, is conducive to your personal mental health?
From NHSC alumni that I have talked to, finding a location that is appealing to you requires some persistence, some hard work, some luck, and a bit of flexibility.
It's hard for me to answer this question at this stage. There are certainly horror stories that you hear of NHSC scholars who were unable to find jobs that suited them, and were "shipped out" to Nowheresville, Montana. I think that it's somewhat easier to find a job in the area where you did residency, and in an area that has had some experience with hiring NHSC scholars (i.e. an area that has been an underserved area for some time). That being said, my own personal difficulties will depend on where I want to go after residency, which depends on a lot of things.
4) Does the NHSC involve itself in any way in your residency selection? That is to say, do they have any amount of influence over where you choose to complete your primary care residency?
No, the NHSC was very hands-off during the residency selection process. You can do residency wherever you want.
That being said, the NHSC does offer seminars on how to pick a residency program, based on your needs as an NHSC scholar. You definitely want a program that has a reputation for turning out good general internists/pediatricians/OB-gyns, etc. You know that, when you leave residency, you will be working as a generalist for a few years. Therefore, you definitely need a program that will prepare you to see a wide variety of patients and issues.