Question about the military... ( 1

Hi, I am not a military spouse, but figured you all would be the best people to pose my questions to. I hope you don't mind.



Hubby just got accepted to med school and so we are looking into how to pay for it. The military scholarships have caught his eye and are a wonderful deal, but I was wondering what the drawbacks were?



If they did need more people in Afghanistan for example, would they pull him out of med school to go?



We already know that residency and where you go when you are done, is really up to what they need at the moment and I think that is fine because worse case scenario, he would be happy training in general med.



What branch gives you the most options?



Is the pay really bad when he is finished? Understand, at this point, making 20k would seem like a windfall!! LOL



Would he have to wear fatigues to work? Would he ethically be compromised because of having to follow protocol? Example, if he thought a patient needed a certain type of care, and someone that ranks higher thought differently, what would happen?



I have lots more questions....but those are a start! And any positives about the scholarship would be appreciated too.



With thanks in advance,

Wifty

OK, Wifty, I thought I'd paste your questions here and answer them in order so I could get to them all (I have a Swiss cheese memory )



"If they did need more people in Afghanistan for example, would they pull him out of med school to go?"



NO! Your husband would be considered an investment by the military and it would be a waste of their money to pay for a year or two of expensive medical school and then pull him out - he wouldn't be able to practice medicine yet so they could only use him as a general officer. So, it would not be in the best interest of the military - it's not going to happen.

.



"What branch gives you the most options?"



When Jon was exploring this avenue he decided that the Air Force seemed to be the most friendly towards its physicians and there is not a "general medical officer" requirement that interrupts medical training like you find in other branches. Of course, he was also biased as a "legacy" of sorts - his dad was an Air Force officer (piloted jets).



"Is the pay really bad when he is finished? Understand, at this point, making 20k would seem like a windfall!! LOL"



I hear you on the making ANYTHING would be great mindset (that is how I felt all through med school) As far as the military pay, it depends on the specialty he pursues. If he goes into peds or general medicine, the pay in the military is actually quite good and comparable to civilian pay. If he goes into surgery or radiology (the latter being my husband's specialty) the pay is not just lousy, it's slavery by comparison of civilian salaries. The navy did a study on the comparison by specialty of military vs. civilian mean and average salaries and the military pay for radiology in particular was a THIRD the AVERAGE civilian salary for a radiologists. No wonder they have an incredible turn over rate for the specialists!!!



"Would he have to wear fatigues to work?"



No - if he is in a military hospital he will wear a military uniform (similar to wearing a suit and tie everyday - just the uniform attire - at least that is our experience in the Air Force). If he does a civilian residency he wears whatever the program's dress code calls for (ie no uniform). There are isolated events that may require your husband to wear fatigues to work once he is active duty and working in a military hospital - but these are few and far between.



"Would he ethically be compromised because of having to follow protocol? Example, if he thought a patient needed a certain type of care, and someone that ranks higher thought differently, what would happen?"



I haven't a clue, but I do know that his license could be at stake if he does something medically illegal/unethical. I can also tell you that rank is an entirely different thing in the medical field as opposed to everyday military personnel. If you have two physicians - one has more experience than the other medically, but a lower rank than the other physician (the one with less medical experience), then the MEDICAL experience will have more bearing than rank for the most part. In the Air Force, all finished physicians are automatically given a Captain rank. They advance based on a number of criteria, but in our limited experience doing rotations through AF hospitals, rank never came into play - they were run for the most part like a normal hospital.





"I have lots more questions....but those are a start! And any positives about the scholarship would be appreciated too. "



If you want to pay for a family and don't mind giving up a degree of control over your medical career (at least for a few years) then it is a good thing. It has all worked out beautifully for us (to date). The lower pay while he's in the military is a stinky thing, but in the end we also came out of med school with a MUCH lower debt, could afford to feed our three children, and have a higher income in residency than the average resident. It all evens out in the end I suppose.



Also - in our experience recruiters really are NOT the best source of info on military scholarships. It is a very good thing for you guys to find out from people in different stages of medical training and in different military branches what their own experiences are with the military. What I'm trying to say is you are doing a good thing - you might also want to check out the studentdoctor.net site and ask these same questions - you'll get a lot of responses!



Jennifer

Jennifer -



Thank you SO much for all the info!!! I actually did ask some people on SDN right before I read your post.



It really helps knowing that rank is not as important in the hospital as experience. Hubby is extremely ethical and what would have made the military too hard, would be a situation where he was in the right but because of rank, had to treat a patient in a way that he did not agree with. I know that such things rarely happen in real life and are more to be found on 'ER', but that was the only part that he was really worried about.



Did you get health insurance while in med school?

Are you able to sort of decide where you want to work off your service or do they just decide for you?



I agree with you though....I think it all evens out in the end and not having the huge debt....would be nice. Hubby worked it out and assuming loans of about $200,000 at least for the 4 years....to pay that off in 10 years at 8% interest....would be monthly payments in the $5000 range!!!! Its the interest that kills you.



Besides, I have moved 24 times already in my life.....so I have that part down! LOL



Take care and thanks again for the info!!!!

Rebecca

[DCJenn]

Hello again- and yes, I am procrastinating at work!!!



Ok- the Army medical site is something along the lines of http://www.amedd.army.mil or something mighty similar. Do a search and enter HPSP and military and you should be able to come up with some answers.



I know that the research opportunies are awesome within the military- many meds and new techniques and procedures are developed wihtin the military system- they have the luxury of being employed by the feds with all of that money and the research facilities.



My husband's school was on the grounds of Bethesda Naval Medical Center, across the street from NIH so...they had a lot available to them, even as students.



To my knowledge, all of the military hospitals are training hospitals so the opportunities to teach are always there on the inpatient level.



If you guys go that route, he'll have the opportunity to do some rotations at the miltary hospitals- and then you can see for yourselves where you might want to end up. All of my husbands rotations were at military hospitals (of course- there was no option for a civilian residency!) but he was able to do some at Air Force and Navy hospitals, too, which was very nice. (poor dear suffered through December in San Diego one year)



Jenn

[DCJenn]

Hello-



This is the Army Spouse Jennifer here-



"If they did need more people in Afghanistan for example, would they pull him out of med school to go?"



Ditto for the Army- at this point they are a liability and having them exposed to actual warfare is not in their best interests.



"What branch gives you the most options?"

Rick was prior service (enlisted Ranger) with the Army so he always planned to go the Army route. However, I have heard that for females physicians, the Air Force is better about leave and having kids, etc.



"Is the pay really bad when he is finished? Understand, at this point, making 20k would seem like a windfall!! LOL"



My husband makes exactly what any other Army captain with 8 years prior service (4 enlisted and 4 at USUHS- the military med school) makes but they do have a pretty sweet bonus that kicks in after residency- and increases every year that they stay in. And we're lifers since after residency and the time owed (7 because the whole way was paid by going to USUHS)



"Would he have to wear fatigues to work?"

They have the option of wearing the Class B uniform (kinda like a suit- but they are sooooo ugly- the Air Force guys look like bus drivers and the Army guys look like girl scouts, and the Navy- no one looks good in that color khaki) or BDU's (the fatigues). My husband wears the BDU's as he finds them infinitely more comfortable. Combat boots are actually more comfy than dress shoes, although his dress shoes are really Doc Martens with the yellow blacked over so they are more comfortable than the 'issue' dress shoes. They wear their white coats over everything anyway, so it really doesn't matter. And when they are working on the inpatient floors they wear scrubs.



"Would he ethically be compromised because of having to follow protocol? Example, if he thought a patient needed a certain type of care, and someone that ranks higher thought differently, what would happen?"



Again- ditto, rank is entirely different in the Medical Corps. They pretty much all work together anyway. Not that it doesn't matter, but experience is the great equalizer.



My opinion- I wholeheartedly love the lifestyle. Our medical coverage is 100% including medications and any treatments, we get a housing bonus, uniforms are tax deductible, he really enjoyed his medical education- as much as he could, and we owe NOTHING except time. Not one thin dime. We will be lifers, like I said, but a lots of people take advantage of the opportunity and then move on to the civilian world. I like knowing that we'll be able to see different parts of the world, but if you want to 'homestead', they do everything they can to keep you where you want to be- happy docs stay in, after all.



Feel free to ask anything!



(and welcome)



Jenn

LOL The Army and the Airforce Jennifers....thats cute.



I just wanted to say thanks to you Army Jennifer! The info so far has been REALLY helpful!



It makes a lot of sense that you are lifers, and if hubby does it and likes it, he will likely stay for retirement....but all that is down the road.



We would likely have small loans to pay off, since the stipend is not enough....but the loans would be alot less.



Ok, so, is there a simple way of finding out what hospitals are affliated with what branch so we can get an idea of where he could be stationed or what we could ask for?



Oh, and does it seem that being in the military gives them options that they wouldn't otherwise have? Such as working with up-an-coming techniques/equipment or the chance to teach?



Sorry for all the questions!! It just is really hard to find info online. The military sites are completely biased, the med students haven't seen the other side (ie-residency and beyond), and the residents/doctors are too busy to answer questions. So.....you are all I have!



With a smile or two...

Rebecca

Hi,



I have quite a few questions and would appreciate any helpful answers. My husband is not in the military at this time. He used to be a flight surgeon in the navy. He is thinking about going into the air force for a radiology residency. We have heard that the air force/army take good care of their physicians and are in need of radiologist.



I have concerns about the moving aspects now. We have two daughters ages 6 and 4. I have concerns about the impact of pulling them out of school and moving. I have heard most residents when finished will go overseas or to Hawaii. I don't mind that but have heard from several military personnel that the schools in Hawaii are horrible and that most parents home school overseas. This is a huge concern since education is very important.



Do the military schools offer a gifted or advanced learning program? Do they have language and music classes?



Do they have bible schools located on the bases? When my husband was in the navy we didn't have children at that time and were stationed overseas in Italy. I heard a lot of discouragement from the spouses about the schools.



In the overseas billets are you allowed to go off base? We were stationed in Italy during the Gulf War and were advised not to travel off base.



I also have a question about base housing. My husband would be a Major if he went back in. Do you receive base housing right away or do you have to live off base first?



Is anyone's husband in a military radiology residency program right now and if so what are the pro's and con's? What is the base pay for residents? Do they receive bonus's after residency? Has the pay for active duty radiologist gone up? I have heard they are trying to back changes to get physicians.



When you finish your residency do they have a list of billets to choose from or do they hand you orders. I have heard most resident go overseas to the larger hospitals depending on your specialty?



Sorry for all of the questions but some will be deciding factors in our choice to sign up or go to a civilian program.



Thank You,

Carol

I forgot one more question. Does inactive reserves count for time in? He resigned his officers commission after his time.



Thanks,

Carol

[DCJenn]

Carol-



Unless he was called back, I don't think it counts toward pay or retirement.



Jenn

Hey Carol! I'm the Jennifer with a husband in the Air Force in a civilian radiology residency. I'm going absolutely crazy right now so I may have to give you half the info and then post the rest later. For some background on me and our situation go to the intros and read mine.



OK, let me tackle one q at a time:



We have heard that the air force/army take good care of their physicians and are in need of radiologist.



Oh, yeah. The Air Force is DESPERATE for radiologists. They are doing whatever they can at the moment to fill their slots. My husband along with several others was offered, for the first time in history, the opportunity to choose the residency program in radiology they desired and the AF would fully fund it all (in addition to getting active duty pay but that gets into another question). The problem is due to several factors: Radiology is a "lifestyle" speciality (ie you see your family more than many other docs and it has fabulous hours and pay in the civilian world). Because of this in recent years (the last three to be specific) radiology has become killer to get into. Also, historically the military allows commissioned officers to resign if they are passed over for promotion twice. Military doctors often used this "loophole" to get out before their contracts were up (normal military physicians have to go through some rather inane things to be promoted beyond Major and many have chosen just to be passed over and get the heck out). This loophole is in the process of being closed btw. Finally, many radiologists chose to take this way out because the average pay for a radiologist within the military is about a half to a third (depending upon what region of the country) what a civilian radiologist would START OUT at.



I have heard most residents when finished will go overseas or to Hawaii. I don't mind that but have heard from several military personnel that the schools in Hawaii are horrible and that most parents home school overseas. This is a huge concern since education is very important.



Education is a biggie for us as well. There is a group of military homeschoolers located in Hawaii. Here's the link for the military Yahoo! group where you might be able to find some more info: groups.yahoo.com/group/mi...omeschool/ and here's another one: groups.yahoo.com/group/Ho...lMilitary/

We are going to homeschool.



I also have a question about base housing. My husband would be a Major if he went back in. Do you receive base housing right away or do you have to live off base first?



It depends upon the base. Some bases have a waiting list of six months others have a waiting list of up to three years! Your husband will be treated with the same priority as any other Major with dependents when it comes to base housing. We will be opting to live off base unless we go overseas. From what I've heard not too many military physicians ever actually live in base housing.



Is anyone's husband in a military radiology residency program right now and if so what are the pro's and con's?



My husband is in a civilian radiology residency program right now. He wasn't given a military rads residency position, and for career reasons it is probably for the best. The civilian program that he is going to (which his slot there is funded by the military) will look much better on a resume. The pros? Well, you get to live on or near a base (we will be far from one, right now we are two hours away from his "base" technically). You will be payed as an active duty officer - although with my husband's program he is in a civilian hospital but will be paid the same as someone in a military rads program. Cons? I've heard quite a bit about bias in the civilian medical world against those who have served residencies in military hospitals. I don't know if it is completely true, but I've heard of it.... Also, you don't interview for which training hospital you go to - you are assigned a residency hospital. There are very few rads slots in the Air Force because they don't have the facilities to train more than a few in-house (the AF bases with rads slots are: Travis, Lackland, Patterson, and one or two more have a slot or two but I can't remember which ones off the top of my head).



What is the base pay for residents?



If you are active duty it is the same base pay as the corresponding rank within the military branch you serve. IE My husband is currently a Captain in the AF, his base pay is what any Captain in the AF with his years of service would receive. If your husband is not in a military residency position he would *normally* be considered in the reserves and would receive a stipend in addition to what his civilian residency program payed him (he wouldn't go active duty until after residency). If your husband does an abnormal route like mine did, he will be in a civilian hospital but the military will consider him active duty and pay him accordingly (the civilian hospital won't pay him - so it's not double the income unfortunately ).



Do they receive bonus's after residency?



Any active duty medical officer recieves a bonus according to their rank and years of service as well as according to their level of training. My husband knows a link to the exact chart with the current data on this. I will post it as soon as he comes off call tomorrow.



Has the pay for active duty radiologist gone up?



In the Air Force the pay for an active duty radiologist of a certain rank is the same as a family practitioner, pediatrician, ob/gyn, etc. of the same rank within the Air Force would be. There aren't any special radiologist pays that I know of. And therein lies the rub: If you are an internist what the military pays you is on par with civilian average salary. If you are a radiologist the military pays you the same as an internist and you therefore, take a huge paycut.



I have heard they are trying to back changes to get physicians.



I've heard the same. I've heard that with internal medicine, at least, the Air Force is changing procedure on promotion. Pay isn't something I've heard about change-wise. Although, if the Match system (NRMP) gets sued to death and dies competition will ensue among residency programs in the civilian world and the military will find itself working hard to compete for high-quality physicians. In that case you might see the pay rise in order to compete with the civilian sector.



When you finish your residency do they have a list of billets to choose from or do they hand you orders. I have heard most resident go overseas to the larger hospitals depending on your specialty?



Physicians within the military have told my husband that you are, indeed, given a list of billets to choose from and they then "take that into account" before they hand you your orders. I don't know about being sent overseas. I do know that the more specialized a military physician is, the narrower his possible choices of location.



Other things to know: What Jenn said about cost of living is correct. If you are in Texas it will be much cheaper (and thus less pay) than the East or West coasts.



So, here are the possible routes your husband could go if he enters the Air Force in medical school (with the HPSP):



1)Is immediately sucked up into an Air Force military residency on-base in a radiology program. He would then be active duty and paid accordingly. He would owe four years of active duty service once his military residency is complete.



2)He is not taken into an AF military residency and must do the Match and go into a civilian radiology residency. He will be considered in the AF reserves at that time and paid accordingly. Once he completes residency he will become an active duty officer and will owe for all time he was in civilian residency. He will owe four years of active duty service once his civilian residency is complete.



3)He is not taken into the Air Force military residency but is given the option to go on a "sponsored residency". That is what my husband is doing. He will have to locate a program that will accept him outside of the Match and the military will fund his slot (the residency program will get a "free" resident). He will be an active duty officer and will be paid accordingly. Orders will be written based upon where he will be working in a civilian hospital. He will owe four years active duty service for medical school and five + years active duty service for residency once residency training is complete. These years cannot be served concurrently, therefore he will owe 9+ years.



I forgot one more question. Does inactive reserves count for time in? He resigned his officers commission after his time.



No, inactive reserves does not count for time in. Time in for the purposes of paying the military back for medical school and residency is counted as full active duty service once residency training is complete. That means that, although my husband is active duty, his time does not count in paying back for medical school. He will start paying back for medical school once residency and fellowship is complete. He will also owe for residency since it was a military sponsored one.



I hope that explained things! I'll get that link for the pay chart from my husband and post it ASAP!



Jennifer

WOW! Thanks for the low down. If I understand right since my husband is already a practicing physician and will just be doing a residency he will owe four years back. He has already done a intership and is a family practice doctor. He is unhappy with the direction of family medicine and is focusing on radiology.



When my husband was interviewing for Family Practice residencys he was already out of the Navy. The programs liked that he was prior military and added that as a plus.



How did you go about picking a residency outside the match and having it funded by the air force? Which program did your husband choose and like the best?



My husband has already talked with the air force and they seem interested in working something out.



Thank you so much.



Carol

[DCJenn]

Carol-



another thing to keep in mind (something that I personally see as a benefit) is that as the services learn to work together- they are realizing that it's stupid to have slots ONLY for one particular service. For example, one of the Air Force pediatricians has been given an Army slot in Germany. Why? because he was a good match for the job. He's psyched, the Army slot is filled and the Air Force doesn't have to find a place for him. This is going to happen more and more. So, this means that opportunities to actually get to where you wnat to go are going to grow as they cross services to meet the needs of the hospitals.



All of the services are desperate for certain programs. Each has their own niche. Each has thier own requirements and needs and any service would be happy to figure out what you guys would need to do or not do.



Jenn

Hey! Here's the link for the possible places you can be sent in the military. Jon just im'd it to me so I could have a look-see:



afas.afpc.randolph.af.mil..._links.htm





Jennifer

How did you go about picking a residency outside the match and having it funded by the air force?



Well, they actually came to him at Match-time with the offer. They offered it to three people total. It's not a common thing - well, it wasn't until now. Since your husband is already a physician, this is what I would do: Ask about a "Civilian Sponsored" residency. This is exactly what my husband has. The AF is doing this because of the extreme competitiveness of rads residencies and the fact that they simply don't have the training facilities to train as many rads as they are anticipating their need to be.



Which program did your husband choose and like the best?



Once Jon was given this offer and accepted it, he made a list of all of his "dream" residency hospitals. He called all of the radiology program directors for these institutions and told them about the offer. They then all told him to fax his cv and set up an interview. Brigham and Women's Hospital was at the top of his list (his first choice) and he decided to interview there first. He was offered a position there a couple of days later and accepted on the spot.



OK, here's the link for Medical Officer pay tables:



afas.afpc.randolph.af.mil...efault.htm



Jennifer

Thank you, again. This is very very helpful.



Carol