The Health Professions Scholarship Program, or Getting Uncle Sam to pay for medical school

CPR class in Bagram, Afghanistan

CPR class in Bagram, Afghanistan

As a medical student on a military scholarship, I get a lot of questions about the benefits, the downsides, and how to go about getting your very own military scholarship. As part of a series of posts about the military Health Professions Scholarship Program (HPSP), today we will be talking about the basics: what it is, what it pays for, and when it may be a good deal for you. Keep an eye out for future posts, where we will discuss alternatives to HPSP, how to apply for HPSP, the military match, and other aspects of military medical education. So, without further ado…

What it is
The military Health Professions Scholarship Program, or HPSP, is a program that provides a pathway for students to complete their medical training and then serve in the military as physicians. Each of the major branches of service has its own HPSP: the Army, Navy, and Air Force. The Marine Corps doesn’t have its own medical personnel, they use Navy medical personnel, so there is no Marine Corps HPSP.

The general rules are the same for all three branches, with some nuances. These will be covered in another post in this series. I am coming from an Air Force perspective, so bear in mind that while I have classmates who are in the Army and Navy and I have asked them about the finer points of their programs, I am the most knowledgeable about my own branch.

You receive your commission as a military officer on receipt of your scholarship, and you remain in the reserves during medical school. By law, as a reservist, you are required to serve 45 days of active duty per year. However, as a medical student you are in a non-deployable status. You can use these 45 days per year for a few things:
– Initial entry training: All HPSP recipients are required to attend Commissioned Officer Training (Air Force), Basic Officer Leader Course (Army), or Officer Development School (Navy) before entering active duty at the end of medical school. Most people try to get this out of the way either the summer before they start their first year of medical school, or the summer between their first and second year. If you are familiar with OTS/OCS for commissioning “line” officers, then think of this as OTS/OCS “lite” – the details vary by branch, but it is definitely a toned-down version of what typical military officers go through. If you already hold a commission (through an academy or ROTC, for example) then you are typically exempt from attending these courses.
– Other training: Air Force students who have already attended COT have the option to attend the Aerospace Medicine Basic Course (AMP 101) during a subsequent summer.
– “Interview” rotations: Early in your fourth year, you will rotate at a military facility as part of your application for residency. For more on this process, see the post titled How the Military Match Works.
– “Campus tour” orders: This is when you are placed on active duty and assigned to your school of record. In other words, you go about your regular day-to-day life with no military obligation, but you are placed on active duty to satisfy the statutory requirement of 45 days per year.

What it isn’t
A free lunch. The military (Army, Navy, or Air Force) is choosing to invest in training you – paying for your medical school as well as the additional training that it takes to make you a military officer. They are doing this with the understanding that you will serve as a physician in that branch of the military afterwards, for a specified amount of time. The exact length of time that you owe as “payback time” depends on the details of your training. Again, this will be covered in more detail in another post.

What you get
When you join HPSP, your branch of services promises to pay for a number of things:
– Your medical school tuition and most fees (they won’t cover yearbook fees, pager fees, copy fees)
– Any health insurance required by your medical school, for you. They will not pay for health insurance for your spouse or children, even if your school requires it.
– Any textbooks required by your school (not optional books, not USMLE review books, not question banks)
– Rental of a computer is a computer is required by your school (not purchase)
– Purchase of any other equipment required by your school (white coat, stethoscope, etc) up to a certain limit per item
– Pay (see below)
– Military retirement, but only if you decide to stay in the military for 20 years

The pay during school
During the school year, you receive a stipend of approximately $2,000/month. Unlike the Basic Allowance for Housing (BAH) that is paid to active duty military members, this is NOT tied to the local cost of living. If you live in a cheap area, this may cover your entire cost of living. If you live in Manhattan, it probably won’t, and you may have to take out loans for the remainder.

Each year you are also placed on active duty orders for 45 days (see above). During those 45 days, you receive full active duty pay and benefits. This includes base pay (about $2750/month as of January 2015, you can find updated numbers here. (During medical school you are an O-1, and you will be promoted to O-3 on graduation. You skip O-2 altogether.) You also receive a housing allowance, which depends on your location. Up to date information can be found

Residency
One of the major possible downsides of HPSP is that you must go through the military match. The vast majority of HPSP recipients are required to complete their residency in a military program, and your odds of training in a civilian program vary depending on your branch of service. For more information about the military match, see my post on the military match.

What you owe
In exchange for all of this, you owe the military a certain number of years on active duty as a physician. Generally, you owe one year on active duty for each year of scholarship that you received. Since you can receive HPSP benefits for 2 years, 3 years, or 4 years, your obligation may vary. During this time, you are a military officer receiving full military pay and benefits, plus some extra medical pay. Depending on your specialty, in 2014 you can expect to make about $100k-150k/year. This is a really good deal for a pediatrician or family medicine doctor, who might only expect to make $80-100k/year as a civilian, minus having to pay back those loans. It is a lot less appealing for someone going into head and neck surgery, who could make $200-300k/year as a civilian. Note that this obligation is served AFTER you finish residency. Speaking of which…

What’s the deal with military retirement?
In the military, you aren’t “vested” in the pension system until you serve 20 years. If you serve 19 years, you get nothing. If you get a four year scholarship and go into internal medicine, you will get 0 years of retirement credit for medical school (because you are a reservist), 3 years of credit if you do an active duty residency, and 4 years of credit for your payback time, for 7 years total. If you want to get the military retirement benefits (which are AWESOME), then you need to stay for another 13 years.

When is it a good deal?
– You want to go into a specialty that doesn’t pay well in the civilian world (primary care)
– You plan to attend a medical school with high tuition. Since HPSP pays your full tuition regardless of dollar amount, it is worth a lot more if your tuition is $60k/year than if your tuition is $10k/year.
– You have already spent time in the military. If you have already been in the military, those years in service transfer over, and while you won’t get anything extra during most of medical school (and will still be an O-1 like the rest of us), you do still get the extra pay during your active duty tours while in school and during your active duty commitment after residency. And of course, if you already have years towards retirement, that’s a big bonus!

Alternatives
There are a couple of alternatives to HPSP that also get your school paid for, including HSCP in the Navy and USUHS for all branches. I will talk more about these in an upcoming post.

In the meantime, what questions do you have?

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