Here is my latest project - the military residency wiki. As a student, I felt…
So you want a civilian deferral
January 2016 Update: This page really talks about the Air Force process for requesting civilian deferral, as well as general considerations in applying for civilian deferral. Another post will be coming soon about the Army process.
So you’re a medical student on a military scholarship and you want to train in a civilian residency – you want to defer entry into active duty until after you finish your residency. The first step is to make sure you understand how the military match process works and what you need to do in order to be competitive in the military match. If you haven’t already read my article on the military match then I would strongly encourage you to read it now, because I am going to assume going forward that you know and understand everything that I talk about there, and we are going to focus just on the peculiarities of seeking a civilian training spot in the military match (and the civilian match).
The first question that I am often asked is “How hard is it to get a civilian deferral?” If you read the article on the military match then you already know that this largely depends on the number of civilian deferrals that are available in your specialty in the year in which you apply. For example, in the military match for the class of 2014, there were 3 civilian deferrals offered in OB/GYN in the Air Force. The following year, there were 9 civilian deferrals. This is the luck of the draw and there is really nothing you can do about it.
But how do you know how many spots there are? In the Air Force, a document called the HPERB comes out in June. I don’t actually know what that stands for – even in writing, I always see it described as just the HPERB. (If you know, leave it in the comments!) Anyway, the HPERB lists every spot that is approved and funded for the following academic year, in each specialty and location. As an example, you can see the 2014 HPERB here.
The more spots there are in your specialty, the better your chances. So look at last a few years’ worth of HPERBs and try to get a sense for how many spots there have been lately, bearing in mind that this may change by the time you apply. When the HPERB comes out in the year that you will apply, read it and read it carefully.
Things that are going to affect your chances of matching to a deferral in the military match, but that you have no control over:
- Number of deferrals available for your year
- Extenuating circumstances (yours or someone else’s). If someone else has a geographically-limited spouse and kids, for example, and you don’t, that could hurt your chances of getting the deferral.
Once you have that information, it’s time to develop your plan. Remember that if you rank civilian #1, you have to say why in your personal statement, which is already limited to one page, double spaced. So figure out how you can explain your reasons for wanting a civilian deferral in a sentence or two, so it doesn’t overwhelm the rest of your personal statement. The same thing will happen in your interviews, so be prepared.
Things you can do to boost your chances of matching to a civilian deferral in the military match:
- Good USMLE scores
- Do military away rotations and perform well
- Be able to clearly articulate why you want a deferral
Now let’s fast-forward for a minute, and assume that you got the deferral that you wanted. Congratulations! Now what? Remember that you still have to match into a civilian program, and that isn’t as easy as you might think! As military students I think we tend to worry about the military match the most, but the civilian match is just as challenging! In fact, 2015 was an extremely challenging year for the civilian match (read more here).
While you were going on military away rotations to boost your odds of getting the deferral that you want, your civilian colleagues were doing away rotations at the programs that they want to match to. Now you are behind the curve. If you can find the time in your schedule, it is probably worth trying to do a civilian away rotation at a program that you would like to attend.
And here’s the real kicker, and something that they don’t advertise. A few weeks after I received my military match letter, I got my new contract from the Air Force. In this new contract, I had to agree that if I failed to match to a civilian program of the length and specialty that I was assigned, then I would scramble into a PGY-1 only program in general surgery, internal medicine, or transitional year. As I understand it, I would be bumped off the OB/GYN track onto the flight medicine track, essentially, and could end up delaying starting my residency for 5 years (1 year of PGY-1 only, 4 years of active duty commitment as a flight doc, then getting out and starting an OB/GYN residency after that). After all, if I failed to match in OB/GYN once, why should they take a chance on me again?
So, in other words, no pressure.
The last thing to think about is what to say about the military in your civilian interviews. Remember that the military match results come out in mid-December, and the civilian interview season is October-early January, so you will have to most of your civilian interviews before you have the results of the civilian match. It’s hard to stomach all of the money that you will spend to go on civilian interviews when you don’t even know if you are going through the civilian match, so be prepared! For me, the potential consequences of not matching were bad enough to motivate me to apply to over 50 programs in ERAS and attend 16 interviews (I was offered 4 more that I either declined or canceled).
There is a box on the ERAS application that you check to indicate that you have a military commitment after residency, so all of the program directors know. There is absolutely no point in hiding your status. How you approach this topic when it inevitably comes up has a lot to do with how you ranked civilian deferral compared to the other options. For example, in my interviews, I said something along the lines of
Yes, I am on an Air Force scholarship so I will owe them 4 years on active duty after residency. I have requested their permission to train in a civilian residency, but they may assign me to a military program or to a PGY-1 only. I will know the outcome of the military match in December, and I will be in touch as soon as I know definitively whether I will be seeking a position in the 2015 civilian match.
Of course, that is assuming that I get an interview…
Finally, there is some extra paperwork (the Air Force needs an official letter of acceptance from the program, for example), but it’s really no big deal and the coordinators will walk you through it.
So that’s it! Everything you need to know about matching into a civilian deferral in the military match. What do you still want to know? Please leave your questions and thoughts in the comments. For people who have been through the military match, what was it like for you?