Here is my latest project - the military residency wiki. As a student, I felt…
How the military match works (as of 2014)
As a graduating medical student on a military scholarship, I get a lot of questions about how military scholarships and the military match work. I plan to write another post in the near future that explains how the military scholarships work in general, but since it’s match season, let’s talk about the military match process first.
I’m going to assume that you don’t know a whole lot about the military match and explain it from square one, so please forgive me if I’m saying a lot of stuff that you already know. I figured better to explain too much than too little! I am coming from an Air Force background, so I know more of the details of the Air Force system than the Army or Navy. If something is specific to the Air Force, I will indicate that.
We will start with some terms:
- NRMP: The civilian National Residency Matching Program (aka the “main match” and the SOAP or scramble), which matches students into positions at the civilian residency programs
- ERAS: The Electronic Residency Application Service, the civilian residency application used by all programs. Think of this like the AMCAS service that you used to apply to medical schools. The difference between AMCAS and ERAS is that there is no “secondary” application in ERAS. Remember those 5 pages of essays that you had to write for every single school that you applied to? Not this time!
- JSGME: Joint Services Graduate Medical Education. This division runs the military match, and the military residency application is submitted to them. Think of JSGME as the military equivalent of NRMP. Each service also has its own office responsible for the match.
- MODS: This is the military equivalent of ERAS, where you submit your application electronically. As of 2014, all three branches which have residencies (Army, Navy, and Air Force) are using MODS. In September, you submit your application and rank list (the list of which specialties and programs you are interested in, in order of preference) into MODS.
- HPERB (Air Force): The list of how many residency training slots will be available in each specialty and location that year. This is released by the Air Force Physician Education Branch in June each year. A similar list is released by the other services around the same time.
- Civilian deferral/deferred: This refers to a resident on a military scholarship who has been granted permission to train in a civilian program. In deferred status, you remain an inactive reservist. You collect no military pay or benefits (though you still have an ID card and can use the commissary, etc) and you have no military obligations until you complete residency. Training in this status does not increase your military commitment after residency graduation compared to training in a military program. However, you will be paid less than a military resident (usually starting around $50k/yr for a civilian vs $70k/yr for a resident in a military program). The number of military training slots in a particular specialty tends to be pretty stable from year to year, but the number of civilian deferrals varies greatly. This means that one year it may be very easy to get a civilian deferral, and the next year it might be nearly impossible.
- Civilian sponsored: I haven’t seen too many of these appear recently, but this status is a hybrid between an active duty residency and a civilian deferral. You train in a civilian program, but you are on active duty and collect full military pay and benefits. As with civilian deferral, you have no military commitments during your residency. Training in this status accrues an additional year of active duty “pay-back time” after residency per year of training. For example, if you receive a four-year scholarship and complete a 4-year residency in a civilian sponsored status, you will owe 8 years on active duty after you complete your residency.
Let’s assume that, in a given year, there are 9 military training slots and 3 civilian deferrals in your specialty of interest. So that makes 12 total people who will train in that specialty. The board, which is made up of all of the military program directors in that specialty, sits down at a big table and looks at all of the candidates. First, they decide which 12 are going to train in that specialty. Then they look at who wants to go where. Who gets what they want depends on whether your top choice program wants you, and whether you have extenuating circumstances such as a spouse in residency in a certain area, family in a certain area, etc.
So how do you get the spot that you want, whether that is in a military program or a civilian deferral? There are two basic things that you need to do. The first is that you need to be selected to train in your specialty of choice, period. To do this, you need to pass Step 1 and Step 2, obviously, but what really matters to the board is whether they want to work with you. They don’t really care about your actual Step 1 or Step 2 CK scores, or your grades. To prove that they want to work with you, you have to do military away rotations and perform well. You are required to do one military away rotation as a condition of your scholarship, but it’s a good idea to “save” your active duty tour from your third year so you can do two military away rotations (if your specialty of choice has at least two military programs in your branch of service). Interview at some of the others in person if you can. In a specialty like OB/GYN where there are only a few programs, it is a good idea to at least telephone interview everywhere. If your specialty of choice has 15 programs, you may not need to interview everywhere 🙂 Either way, you want as many people at that table rooting for you as possible.
Then it comes down to two things: whether the program that you want, wants you, and whether you have a convincing reason why you need a particular location, or a deferral. When you submit your military rank list, if you rank civilian deferral first, you have to give an explanation for why (family, etc) as part of your personal statement. If you rank it second or lower, you don’t have to explain your choice, but if you have a good reason for it, it would be wise to explain that to the military program directors during your interviews.
It is important to be aware of another idiosyncrasy of the military match. The Army and the Air Force match people to a full residency, PGY-1 (intern) through graduation. The Navy initially matches everyone to a PGY-1 (intern) year only, and you must re-apply to continue in training. The majority of interns are, instead, sent out to the fleet to serve as general medical officers (GMOs) (primary care doctors) for a few years between their intern year and their PGY-2 year. I will talk about this in more detail in another post.
Is that all clear as mud? Please feel free to post your questions and I will answer them as best I can. Also keep an eye out for the other posts in this series – I will be writing about how military scholarships work while you are in school, how to apply for military scholarships, and ways to decide if a military scholarship is the right choice for you. Thanks for reading!