Matthew McDougall, MD
[Editor's Note: This is a guest post by Matthew McDougall, MD, a regular reader and a PGYII in Psychiatry at the University of South Dakota. In medical school, he was an Army med student/physician recruiter. We have no financial relationship.]
The Army National Guard Program For Physicians
Like all areas of the military, the Army National Guard (ANG) needs doctors. I'm sure you've seen the commercials for the Guard before- one weekend a month and two weeks a year. Plus, you get deployed from time to time but are limited to 90 days “boots on ground” (plus 30 days for in/out-processing) which is far less time than many active duty and reservist doctors do. These deployments can be as frequent as every 2 years, but are generally every 3-5 years. You're a part-time soldier, and when you're a doctor joining, you're a part-time military doctor with all of its pluses and minuses. Just like the active duty military, the Guard does not deploy medical students or residents.
The National Guard has a Flexible Training Policy that only requires medical professionals to drill at their unit of assignment six times in any calendar year. Remaining drill time can be spent split-training in suitable career oriented activities (call, research, study, presentations, etc.). This policy is up to the unit commander's discretion, but many medical commanders understand the rigor and time commitment involved with medical school, residency and practice. In addition to being flexible with training, they often allow ample time to study while drilling at the unit of assignment.
You will drill with a National Guard unit near your medical school, residency training program and practice. State to state transfers are, for the most part, efficient. If you’re planning on moving from California to New York, you’ll find a home in both locations. Many residency programs, future employers, and your community will look favorably upon you because you have proven service beyond medical school and residency. You have also demonstrated a selflessness that is essential to becoming a valued physician.
If you are a medical student, you will not be told to apply for a specific specialty. You will enter the CIVILIAN residency match and will match at a CIVILIAN program. Once out of residency, you will work in a CIVILIAN job. Therefore, you can take advantage of CIVILIAN bonuses and practice options. If you join the ANG as a medical student and match into a specialty not on the list, then you will serve your commitment with the Reserve, instead of the Guard.
Anyone who does not have prior service in the military, must sign an “original” eight year contractual agreement. The time in this agreement can be served in the active duty forces, the Reserve component, or the Individual Ready Reserve (IRR). The Army National Guard uses a “six and two” model, meaning that soldiers need to be in active drilling status for six years before they can join the Individual Ready Reserve (IRR). Troops in the IRR are not obligated to drill, or “serve,” unless called to action by the president. They essentially go about their life with little connection to the military. [Note this is different from the active duty, where you generally commit to a 4 year period of active duty and 4 years in the IRR-ed]
Eligible Medical Specialties In The Army National Guard
The ANG is interested in a broad range of specialties, but not all of them. It designates its desired specialists via a “critical skill shortage list” and includes General Surgery, Internal Medicine, Psychiatry, Family Practice, Emergency Medicine, Neurology and the subspecialties of these fields.
Benefits of Joining The Army National Guard For Doctors
The Army National Guard provides a combination of state and Federal incentives. Federal incentives are standard from state to state and are even mirrored by other branches of the Reserve component. These incentives include:
- Student loan repayment of up to $240,000 (Only pays for medical school loans).
- Stipends of more than $2,100 a month while in medical school and residency.
- Yearly bonuses of up to $25,000 for board eligible and board certified physicians.
- Montgomery G. I. Bill – $350/ month tax free for 36 months during school or training
- Monthly drill check of at least $400 as a medical student, $600 as a resident and $800 as an attending- increases with promotions and additional time in service
- Reimbursement for medical licensing exams
- Paid externships at military facilities
- Up to 5 days of paid CME (up to $2500 reimbursement plus pay and benefits)
- Access to Tri-Care Reserve Select Health Insurance – $50/month for you, $200/month for the whole family
- State incentives vary but can include automatic state residency at your medical school or state tuition assistance which may cover up to your entire tuition (such as the University of Medicine and Dentistry of New Jersey)
- Other benefits include an opportunity to travel abroad and do relief work, additional military specific training, mentorship opportunities, leadership opportunities, and optional but exclusive military opportunities such as military teams, combatives training, and flight surgeon training.
Medical and Dental Student Stipend Program
The program for medical students is called Medical and Dental Student Stipend Program (MDSSP) and pays $2100 a month in return for a 2 for 1 commitment. So if they pay you for 4 years, you owe them 8 years after residency.
Specialized Training Assistance Program
The program for residents is called Specialized Training Assistance Program (STRAP) and pays residents the same $2,100 a month as the MDSSP. Resident physicians qualify if their chosen specialty is on the Critical Skills Shortage List. Like the MDSSP, taking this incentive obligates a resident to two years of duty for every one year of incentive, payable after the completion of residency. However, if you take STRAP with an equal or lesser amount of MDSSP, the MDSSP obligation drops to a one to one commitment, and the STRAP obligation is made payable upon completion of the MDSSP obligation. So if you get paid for 4 years of med school and 4 years of residency, you'll only owe 12 years on drill status, not 16.
Health Professions Loan Repayment Program
The Health Professions Loan Repayment Program (HPLRP) pays up to $240,000 in medical school loans. Loans are paid in yearly $40,000 increments for up to six years or until medical school loans are exhausted. Board certified, board eligible and resident physicians all qualify if their chosen specialty is on the Critical Skills Shortage List. The HPLRP incurs a one to one obligation; the obligation for HPLRP is paid in the year that it is taken. Taking this incentive obligates a board eligible, board certified physician to one year of duty for every one year of incentive, payable in the year that the incentive is awarded.
Residents who take HPLRP must take it in conjunction with STRAP and they can only take it after completing the second year of residency (PGY2). If a resident elected to take STRAP with HPLRP at the start of PGY3, the resident would be need to fulfill both the STRAP and HPLRP obligation. The obligation for the HPLRP would be paid in the year that it is taken and STRAP payback would begin after the HPLRP is exhausted or upon graduation from residency, whichever comes last. So if you had the Guard pay for 4 years of med school, 4 years of residency, and pay back $160,000 in medical student loans, then your total obligation would be 16 years on drill status.
Look who showed up at WCICON 10 years after writing this post. Huge thanks to Matt for continuing to answer all of your questions in the comments section for the last decade!
Bonuses
Yearly bonuses of up to $25,000 if not fulfilling an obligation for a different incentive program such as MDSSP, STRAP, or HPLRP. This bonus payment is $25,000/year if contracted for three consecutive years, $20,000 for two consecutive years, and $15,000 for one year. Again, specialties must be on the Critical Skills Shortage List. Under current policy, you can only take three years of bonus. The bonus can be contracted at the same time as HPLRP, but payments are made consecutively–first HPLRP and then bonus.
Downsides Of Joining The Army National Guard for Doctors
- You're a military doctor. That means you do what you're ordered to do and have less control over your practice, staff, schedule, and hours than you might like. Your pay and benefits are determined by the military.
- Incentives are subject to change. Sometimes they go away, like when medical school was deemed no longer eligible for the $4,500 in the Federal Tuition Assistance. Sometimes they increase, like when the student loan repayment was increased from $50,000 to $240,000. Bottom line, understand that the incentives will change after you sign your contract. You must be satisfied with your choice and realize that the incentive landscape will shift depending on supply and demand.
- If you’re a medical student, the specialty you choose may not have a slot in the Army National Guard. If so, you will have to transfer to another Reserve component. These components function a little differently than the Army National Guard and can add additional headaches come time for residency.
- The National Guard requires commitment. You will have to work on weekends when you would rather be with friends or family. You’ll have to spend three weeks at phase-two of Officer Basic Leadership Course (OBLC) [i.e. basic training-ed] and you’ll have to complete phase-one online computer training on your own time (You have up to three years to complete Phase 1 and Phase 2 of OBLC while in medical school and residency, and exceptions are commonly granted).
Maximizing Guard Benefits At Each Stage Of Medical Training
The Pre-Med
Apply to medical schools that are eligible for State Tuition Assistance programs like the University of Medicine and Dentistry in New Jersey. 100% tuition is hard to pass up.
Pay less attention to in-state vs out of state tuition for public schools if the state will grant you automatic residency for joining the National Guard.
Sign on the dotted line when you are accepted into medical school. Do all your paperwork and processing prior to acceptance so that, upon acceptance, you can turn around and tell the medical school that you now are officially eligible for in-state tuition and state tuition assistance.
The Medical Student
- Join the National Guard without taking STRAP, drill regularly (using the Flexible Training Policy whenever possible) and collect a monthly $400+ paycheck.
- Utilize state tuition assistance
- Utilize the Montgomory GI bill-Select Reserve (Chapter 1606). The MGIB pays $350+/ month tax free for 36 months while enrolled as a full time student.
- Utilize Tri-Care Reserve Select for insurance instead of an expensive medical school plan
- Have the National Guard cover USMLE exam expenses (only test fees, not travel, some board preparation expenses).
- Go on an externship to a military program, as an MSIII or MSIV, collecting active duty pay and receiving reimbursement for all expenses.
- Incorporate two week annual training experience into medical school curriculum.
- Learn as much as you can from drill and tout your service and new found skill set to residency programs.
- Avoid federal incentives (MDSSP, STRAP, and MPLRP) until PGY3, unless you are ready for a longer commitment
- If you find that you don’t enjoy the National Guard while in medical school, or in the first two years of residency, you can pass on the Federal incentives and go into the Individual Ready Reserve for the last two years of your original eight year contract, without further commitment.
The Medical Resident
- If you haven't already joined, don't until the start of your third year of residency. The first two years of residency are busy enough, no need to make life more difficult than it already is. The STRAP program just isn’t worth it without the HPLRP.
- Throughout PGY2, work on your National Guard paperwork, because it takes time, and sign up for the STRAP program and HPLRP on day 1 of PGY3.
- If you had $80,000 in loans, and followed this plan, taking these two incentives would pay off all your loans by the completion of a 4 year residency, also providing an additional $35,000 in annual income (STRAP plus drill pay) and access to the Roth TSP while in residency. Electing to take these two incentives would not extend the original eight year contractual agreement and you could still enter the IRR in the last two years of your contract.
- If, after six years of service, you really liked the guard, you could sign up for bonuses and possibly even remain until you secure a pension at 20 years.
- This situation becomes more complex with additional indebtedness. If you had $240,000 in loans, you should do as above, but the HPLRP obligation would be paid in the last two years of residency, and the first four years of practice and the STRAP payback would occur in the fifth through eighth year of practice. This would extend your original contract by 2 years and would require four additional years of active drill.
- Don’t forget that you will also receive your monthly drill check, which for a Captain is around $600, CME funding, and access to Tri-Care Reserve Select and the TSP. Plus you will be able to utilize the flexible training schedule and you may be able to incorporate your two week annual training into your residency curriculum.
The Attending Physician
- Take a combination of the HPLRP and bonus. Again, your goal is to meet the 6 year active drilling component of the “original” eight year contract and then decide if you want to continue to draw incentive.
- With $240,000 in loans, only sign up for HPLRP and allow the National Guard to pay your loans in full over the six year active drilling component of the “original” eight year contract.
- If you have anything less than 200,000, take a bonus for the remaining years of the 6 year active drilling component (ie. $200K plus one year of $15,000 bonus, $160K plus 2 years of $20,000 bonus, $120K plus 3 years of $25,000 bonus). Remember, you can contract for these two incentives at the same time (when you sign your original 8 year contract), but they are paid to you consecutively: HPLRP then Bonus.
- Don’t forget that you will also receive your monthly drill check, which for a major is around $800, CME funding, and access to Tri-Care Reserve Select and the TSP. Plus you will be able to utilize the flexible training schedule.
The Prior Service Professional
Prior service professionals do not need to sign an eight year contract and can elect to take incentives in a way that will commit them to less than 6 years of active drilling status.
Medical students and residents may contract a year at a time, and still benefit from state tuition assistance, state residency, Tri-Care, a monthly drill check, retirement points, the flexible training schedule, CME money (after graduating from medical school) and experience. Avoid taking federal incentives with prior service unless done using the suggestions laid out above.
Board eligible and board certified (BEBC) physicians will have similar benefits to the benefits listed in the prior paragraph and can contract for the HPLRP and bonus on a yearly basis. Remember, incentives are subject to change. If you take an incentive on a yearly basis, it could go away before you are able to maximize the benefit.
Additionally, don't forget about retirement. If you have prior service in the military and you didn't put in enough time to reach the twenty year retirement mark, you can finish out your twenty years of service with the National Guard. The military retirement system is a points system. The amount of pay you receive, depends on your time in service and the number of points you have accrued over that period. Since Active Duty service members acquire more points, they have larger pensions relative to their peers with equal rank and time of service in the National Guard. Active duty members are also able to start taking their pension immediately after retirement, unlike National Guard members who must wait until they reach the age of 60. Still, if you are eight to ten years away from a military pension, and you find you enjoy your time in the National Guard, you might as well finish out your twenty years and become vested in a solid pension plan.
Conclusion
If after having read my post, the Army National Guard entices you, then great, go for it! If not, that’s okay, keep looking, there are other opportunities like this, you just have to find the one that meets MOST of your needs and suits your character. The National Guard is not the only available option for physicians. It was the right option for me, and I will be forever grateful for my experience.
Have you considered the Guard? What did you think? Comment below!
I tried to talk to recruiters about 6 months before 9-11, I was told my mild asthma would keep me out. It would have been interesting to see the path that would have taken me on.
Recruiters lied. Asthma, especially mild is almost always waive able for professionals joining. Recruiters always lie by the way (although usually to get you in not out).
I will say this though. While I enjoyed my time in the military I am glad I got out.
While the National Guard pays better than the Reserve for doctors they commitment is much more. In the Reserves, docs are usually activated for 3 months and almost always as back fill to a base to replace a deploying full time provider unless they choose otherwise. Meanwhile National Guard deployments are usually longer and to war zones. Interesting that deployments was left out of the “Downsides of Joining” section.
Beau, thank you for your input, but I don’t think your comment is entirely true. Waivers are definitely available, you are right there, but I don’t think that recruiters purposely lie. I can’t say this doesn’t happen, but I do know that recruiters don’t get any kickbacks or bonuses for bringing in more recruits. They do have a recruitment goal, but they are not fired if they don’t meet their quota–unless they are inept. Furthermore, a physician or future physician should use their extensive problem solving ability to see through any false claims. Policy is available, and I always advocate that new recruits obtain, read and scrutinize Army recruitment policy prior to joining, because recruiters are sometimes misinformed. Recruiters do have access to this information and they will send it to you if you ask.
I can’t say what the Army Reserves does and does not do, but the National Guard also has a 90 days boots on ground policy, and I have known Guard doctors to both back-fill in the U.S. and be deployed abroad. If a Guard doctor wants to stay longer than 90 days, they can extend their tour. Perhaps this is what happened to the National Guard doctors that you knew.
Deployment is covered in the first paragraph of the post, but you are correct, it should be added to the “Downsides of Joining” section, at least for some. I am personally looking forward to any possible deployment and know doctors who have joined just so that they could deploy.
Again, thank you for your insight.
I talked with my NG buddy and he DID offer to stay an extra 3 months.
I am unsure of NG recruiters but I can tell you it is quite common for regular army and army reserve recruiters to significantly stretch the truth when recruiting. It is a very highly stressful job for most because if you don’t meet your quota you are often moved to other less desirable jobs.
I still may join the NG someday. Been considering it but need my practice to develop more first. I am not anti-NG I just think things often get left out of the speech. They did for me.
In my experience, mistruths from recruiters are much more likely to be a result of their not understanding how medical school, residency, and attending life work in the civilian world and the military world rather than deliberate lies. Do some lie? Assuredly. But the big issue with recruiting is it is generally done by an E-5, who hasn’t been to college, much less medical school. Most of them haven’t even worked in the medical field.
Even Dr. McDougall functioned as a recruiter during med school. An attending would obviously be a much more helpful recruiter, but who’s going to pay an O-5 physician to recruit?
Nice article. It seems like a lot of work was put into it. Thanks for the contribution.
Are there any legal protections once you are an attending to protect you during deployments? I would think many practices would have trouble with a physician leaving for 3-4 months. There is still rent, staff, etc. to pay. If this seriously limited your practice options and/or income it might really cut into the benefits of this deal.
Dr. X., thanks for the question. Yes, there is protection for deploying doctors. It is provided by The Uniformed Services Employment and Reemployment Rights Act of 1994 (USERRA). This is a federal law that established the rights and responsibilities for uniformed service members and their civilian employers.
Basically, if you are an employed doctor, or part of a group, your employer or group must guarantee that your position (or an equal position) and pay, plus any promotions or pay increases you would have received had you not deployed, be there for you when you return from deployment.
You bring up a good point when you mention overhead expenses–the lights have to be paid, right? Unfortunately, I don’t know how to answer this question. Fortunately, I do know where you can find the answer. Call the Employer Support of the Guard and Reserve. They should be able to answer your question: 1-800-336-4590. In the meantime, I will look to some of my contacts for a more expedient answer.
I refer you to this website for further information: http://www.esgr.mil/USERRA/Frequently-Asked-Questions.aspx
There are legal protections that keep employers from firing deployed guardsmen. Your private practice might tank though. I don’t think my partners would be thrilled with me if I signed up with the Guard.
Dr. X. I have discussed your deployment question with my contact. He is an upper level administrator at the National Guard Bureau (NGB) that has been involved in recruiting and policy development for many years. He recommended the following strategies.
Independent private practice: Deploying with the National Guard can be difficult for the independent practitioner. Locum tennans arrangements can be made, but they are often expensive and may result in a reduction in patient volume upon returning to practice. Unfortunately, there is no way to ensure against deployment at this time. Back in the ‘90s insurance was available, but it went away after the Gulf War.
Group private practice: If you are already in the National Guard, but not yet in group practice, it is important to be upfront with future group members when in contract negotiations. They will need to be familiar with your National Guard commitment–deployments, drill, annual training–and you will need to find a way to achieve a “win-win” situation. If you are already established in a group, again, be straightforward with your group and work out some sort of compromise. My NGB contact said that in the past, physicians have taken more call in the three months prior to deployment to make up for missed call while in-theater. Other arrangements like this can be made.
Other practice options are not much of a problem. The National Guard is a good match for physicians working in large health systems and for physicians employed by the Veterans Administration and other state and federal agencies. If deployed while working for these places, USSRA will ensure that your position (or an equal position) and pay, plus any promotions or pay increases you would have received had you not deployed will be there for you when you return from deployment.
Medical students and residents interested in the Guard need to carefully consider how deployment might impact their future practice options. I know that thinking about practice options will be way down the priority list, but it is important if one is planning on joining the National Guard. Again, remember that honesty is the best policy and that the Guard can be incorporated into nearly any type of practice option with the right mindset and problem solving approach. Also, remember that the financial benefits of the Guard may be able to bridge the income gap between the private/group practitioner and the employed physician.
One last thing, physicians do have some control over when they will deploy. They can, with the help of their State Guard official, contact the NGB office in San Antonio and coordinate deployment to best suit their needs. Personally, I plan on deploying right after the completion of residency and prior to starting my first gig. I will contact the NGB office about six months prior to graduation to schedule my tour. This will be advantageous for a few reasons. One, I’ll work on my insurance reimbursement paperwork (to get paid) and licensure, while abroad. This will eliminate some of the hassles of being paid by insurance right out of residency. Two, I’ll throw my deployment earnings into the stock market or into passive multi-family real estate, allowing a nice addition to the retirement portfolio. Three, If I choose to work for a hospital system, I can help to alleviate their fears of an impending deployment–they will likely have 3-5 years before I am deployed a second time.
Matt and I serve together in the SD guard, and I am glad he posted some information about the Guard because it definitely is a great opportunity for the right person in the right situation. My last 4 years of service have been a very positive experience (especially serving with some exceptional service men and women). Just out of my own experience (I am a PGY-2 IM resident), I signed with a small private group (5 IM docs and 2 PAs) of traditional internists that still round on their patients and then have their own clinic. They were very happy with me serving and had no hesitations about my possible overseas obligations and my unit drills. We actually wrote in my contract that they would also make every effort to incorporate my guard obligations into our group’s schedule.
Congratulations on the contract Ron! Thanks for your insight!
The pay is usually much lower with any branch of the military even when loan repayment is included. This is a non-wealth building article?
I agree that a significant downside of military service for a physician is the ridiculously low pay, even with loan payment. Keep in mind the Guard is about being a part-time soldier, so you’d still have a lucrative civilian practice to build your wealth with.
I personally don’t think this is a good deal. I made $700,000 my first year out of residency so I just feel any army/national guard thing wouldn’t work for me. I only accumulated $120k in loans in medical school, with an interest rate of 1.5% fixed for 30 years, so the student loan was not an issue to me. In fact my first car cost more than the student loan. Plus being deployed sounds really miserable. Where would have I had to go, Iraq or Afganistan. Honestly, that sounds miserable especially with the type of heat in those places along with my safety.
Jim, you’re probably right, if you are a highly paid physician, the National Guard likely does not make sense from a monetary perspective. Medical students and residents committed to higher paying specialties might want to consider this when thinking about joining the National Guard. There are other ways to pay off student loans, even for medical students and residents with more debt than you and interest accruing at 6.8% during medical school and residency.
Personally, I had a difficult time determining what specialty I wanted to peruse as a medical student and I vacillated between ortho and psych until the end–I really liked psych, but ortho was more egosystonic, as members of my field would say, and paid a heck of a lot better. It was sure nice not feeling as if I had to choose ortho to dig myself out of debt. I was able to keep a more open mind and probably made a better career decision, given my personal circumstances and interests (time will still tell).
Still, I challenge the readers of this financial blog to look beyond the numbers. Financial stewardship is important, but so is self-sacrifice and service to one’s country–at least in my opinion.
I agree it would be a very bad financial choice to pass up a civilian job paying $700K for any military physician job with any available loan payback program, especially for someone who would be miserable while deployed.
Your right Matt. Everyone is different. We really need to thank whitecoatinvestor for doing this blog with his time.
No matter what you make, you need to spend less. I’m just tired of colleagues coming up to me asking me about their whole life policies and then comlaining how badly they are doing. The don’t listen to me, and end up dissapointed.
As far as serving my country, I honestly don’t know what that means. I work as a slave for 50% of my time because of taxes. I deserve a medal for the amount of taxes I pay.
Jim, I didn’t mean that last paragraph to come across as a slight against you or the whitecoatinvestor. You are definitely contributing to the country–more than most–and the whitecoatinvestor is phenomenal–I don’t know where I would be without his financial guidance.
I wanted readers to realize that the monetary aspect is only one reason for joining the Guard. I could write a second post discussing the other reasons, but this blog is not the right venue.
Hopefully, if nothing else, this post will strike up enough interest to draw physicians, both in-training and experienced, into a conversation with like minded physicians in the National Guard. I, for one, would be willing to share my experience and I’m sure others would do the same.
Finally, I don’t mean to idealize the National Guard, because it definitely has it’s imperfections, but I do want others to know that it is a good option if they are interested in military service.
Great article, Matt. It was stimulating and informative.
Only one reason to join the military in my opinion, service to your country. If you join for other reasons, you may have a wonderful experience but you will likely be disappointed overall.
I don’t think people are so black and white that they join “only for money” or “only to serve their country.” There’s a lot more gray to it than that. All of us would like some financial benefit from joining. All of us want to serve our country. We’re all on the continuum somewhere. But I agree that the more service-oriented you are, the more likely you are to enjoy the experience.
Very appreciated and informative post! Just starting to investigate the Guard as an alternative to HPSP, so I find this very helpful. One question about the following though:
“Join the National Guard without taking STRAP, drill regularly (using the Flexible Training Policy whenever possible) and collect a monthly $400+ paycheck. . . If you find that you don’t enjoy the National Guard while in medical school, or in the first two years of residency, you can pass on the Federal incentives and go into the Individual Ready Reserve for the last two years of your original eight year contract, without further commitment.”
Does this suggest that one would regular enlist in the Guard right before medical school as a 68W or something and be a regular old Guardsman for 6 years while in school/internship/residency? That means no mercy for tests/school.
This is a good question. I wouldn’t recommend that you sign on as anything other than a 00E67 (Medical Service Corps – medical student) if you aren’t already a part of the National Guard. Wait until you are accepted to medical school, and then sign your contract. Doing otherwise will confuse the matter. I wouldn’t want you to be pulled away from medical school to go to 68W (medic) school because you thought the switch to 00E67 would be easy.
As long as you are a 00E67, you should still be able to operate under the flexible training policy–therefore you should have mercy for tests and school. I am currently not on incentive (STRAPP, HPLRP, etc.) and I am still eligible for flex training. This was also the case for me while in medical school.
Make sense?
Thanks for the quick reply Matt! I completely agree with you. I was just recently accepted for C/O ’18 and had a conversation with the ARNG rep last week about benefits/obligations/options. When I asked about joining and not taking incentives, he responded like he assumed I meant enlist (implying that he did not consider what you were saying an option or was hiding it). Now that I know you did indeed get to come in as a 00E67 (I didn’t know there was a specific MOS I could reference) without taking MDSSP, I’ll press him on that option. You’re post and response has made me a good deal more informed about my options and I appreciate you for that!
Matt, great article. Thank you! I have a question:
Say I didn’t take any federal incentives at all and simply joined the guard as a 1st year med student. You said I owe 6 years active drill and 2 years IRR. Does this obligation start as an MS1? I.e., I would be in IRR after my 2nd year of residency? Thanks.
Sorry for the slow reply, Jon. I’ve been at a business meeting in Washington DC that occupied all of my time.
You are correct, if you join as an MS1, without federal incentives, you will be able to enter the IRR six years after you sign your initial contract. If you are an MSI when you sign your contract, you will have to actively drill, under the flexible training policy until your third year of residency. (If you join in December of year MSI, you will serve until December of your third year of residency).
Again, read your contract carefully, I am no longer employed as an AMEDD recruiter and contracts do change. That said, I did have this post reviewed from an upper level official in recruiting and retention twice just prior to posting it. It should be accurate, but mistakes and misinterpretations are possible.
Thank you Matt for the reply! I really appreciate the information you’re providing us. Maybe you can write a blog about your experiences in the NG for us that are considering it? There seem to be MANY threads about physician experiences in HPSP/USUHS but it is difficult to find experiences related to part-time service in the Guard.
Anyways, thanks for all that you do.
That’s a good idea, John. I’ve been thinking about linking this article to studentdoctor.net. In the process, I could provide information about my experience in the National Guard. I think I’ve said this before, but, since the White Coat Investor audience is primarily focused on physician finance, I didn’t spend much time talking about the less tangible benefits of joining the National Guard. I would be sure to include some of the drawbacks too…no worthwhile course is free from setbacks…this is true in the National Guard, in medicine and in life.
I’ll let you know if I write something up. I’m pretty busy right now, but should have some available time later this month.
Great post. Question for Matt. I’m late to the thread, but hopefully he’s still listening. Matt, I’m a PGY3 in the guard. I’ve been receiving my STRAP stipend and drilling for almost 2 years now. Everything’s been great. But I’m now up for HPLRP payments this summer. However, I’m not convinced my recruiter has the process down pat, and I want to make sure I get those payments. Could you clarify the HPLRP process for me? Any advice on making it as painless as possible?
See my reply, below.
Hey, Ed. Yeah, I’m still here, and you’re in good luck, because I’m in the process of applying for STRAPP and HPLRP right now myself. While I understand the policy, and have clarified my misunderstandings with the person in charge of writing it, getting the government to cut a check can be difficult. Your best bet is to speak with the AMEDD Technician in your state. You can also try to speak with the Officer Strength Manager. Both of these people should be more knowledgeable than your recruiter and should understand the finer points of the policy.
Since I’m in the process of filing for both STRAP and HPLR, I figured I’d just list the forms that need to be filled out for both:
HPLR requires the following forms be submitted:
DA FORM 5536 (Agreement Health Professionals Loan Repayment)
Amendment to DA from 5536 (this amendment basically says that the Loan repayment went up to $240,000 to be paid in $40,000 installments)
MDSSP/STRAP/HPLR Statement of Understanding
STRAP requires:
NGB FORM 810 (Specialized Training Assistance Program Enrollment Verification)
DA FORM 5685 (New Specialized Training Assistance Program Service Agreement)
USAREC FORM 1103 (Incentive Enrollment Data Sheet)
You may also want to fill out a new W4 to prevent a large tax payment at the end of the year. Go to: http://apps.irs.gov/app/withholdingcalculator/ to figure out the number of exemptions you should elect.
I hope this helps and good luck!
Thank you so much, Matt! Best of luck to you too!
This was a very informative post. I really appreciate the information.
I am a second year resident that is considering going into the Army National Guard, Air National Guard, or perhaps the Air Force Active duty.
Does anyone know if the National Guard deploys you while you are in residency? Also, when do you do your officer training?
The short answer is no, they will not deploy you while in residency. The long answer is, they can, but they have no reason to deploy you until you are fully trained (board eligible/board certified).
That said, if you really want to go, and can work it out with your residency, you may be able to get partial credit for a deployment. This occasionally works for IM and FAMP residents who really want to deploy/want a change from residency. Most of the doctors I talk to really enjoy deployment. Deployment is full of challenges, but it is also very rewarding.
I disagree that deployments are rewarding or full of challenge. Some might be, but certainly not all. Perhaps not even the majority. I did get to read Harry Potter….all 7 of them….while waiting for a ride home after 5 months of caring for diarrhea and rashes though.
When you sign up for the NG, one of the forms you sign is an agreement that you are not deployable until you complete officer training. And that officer training is not typically completed during residency, so you’re safe until after you graduate. Most non-medical people in the NG won’t understand this initially. But the paperwork will be in your service record if it ever becomes an issue.
The key word in that paragraph being “typically.” I can imagine a scenario where you’re ordered to officer training school. Don’t know if it has ever happened, but I can imagine it.
When I joined, I imagined the same thing. But you know, they’ve made several concessions to attract doctors into the guard/reserves (ie. 90 days BOG, flexible training policies, delaying BOLC, etc.). If they start to renege on these things, they’ll have a hard time repairing that reputation. Sure, extreme circumstances may require extreme measures. But it’s just not in the service’s interest to delay your training/board certification when you’re in the middle of it. So, I basically just doubt it would happen. I could be wrong.
A medical professional can be encouraged to attend BOLC (officer training) prior to the completion of medical school/residency, but waivers are commonly granted. Generally, the Guard will want you to complete BOLC within two years of direct commission. An internal medicine doctor that I was at BOLC with joined the guard in his first year of medical school, and didn’t go to BOLC until after the completion of an Internal Medicine residency. Another medical student friend wasn’t able to attend BOLC until his MS4 year and he joined in his MSI year.
You should know that an officer must complete BOLC to be eligible for incentives like the Montgomery GI Bill. I don’t think that this requirement applies to HPLRP and STRAP/MDSSP, (in fact, I’m almost 99% certain it doesn’t) but I need to check to be sure. I do know that as recently as February 14, 2013, the Army National Guard (ARNG) put out a memorandum to the incentive policy stating that the ARNG will no longer require Army Medical Department (AMEDD) Officers Basic Course (BOLC) for medical professionals as a condition to receive the Special Pay Bonus. Special Pay Bonus is different from HPLRP/STRAP/MDSSP in that one must be board eligible and board certified to qualify for the $25,000 per year.
Any update on whether or not BOLC needs to be completed prior to contracting for HPLRP?
I’m sorry, I haven’t had a chance to seek more clarification and I don’t believe the newest incentives manual (published March 2015) covers this detail. It might be best to talk with your recruiter. I will try to circle back to this question when I return from a business trip. Please remind me if I don’t get to it within the week.
Hi Matt,
I’ve seeked clarification on this, but no clear answer. I remember that I posed this question a while back. Have you gotten any updates?
No I haven’t. I’m sorry.
How do you (or who do I contact) apply for a waiver? I’m currently an MS4, never went to BOLC (due to administrative problems in my unit) and now they are telling me I will be decommissioned if I don’t drop out of rotations and attend BOLC.
Thanks!
I hope the guest author can answer this. Part of the issue of joining the military is that there’s always the possibility of stuff like this coming up.
Have you tried talking with your training NCO and your commander? If they are of no help, I would work up your chain of command. Are you in an Army Support Medical Company? Medical Command?
I know that waivers have been granted in the past, and I would be surprised if they would decommission you because you are not able to make it to OBLC prior to the completion of medical school. Particularly if you were not able to make it earlier because of administrative problems in your unit. You are to valuable to the National Guard to have them decommission you that easily.
Do you have any elective time in your 4th year? If so, can you convince your deans office to allow you to get elective credit for BOLC? Do you have any vacation time that you can use? The last I checked, the course was only 3 weeks.
Please contact your state g1 and have them look at AMEDD policies. We ran into similar problems but our G1 said there was policy to protect medical students. I would however get scheduled as soon as possible
Thanks for such a well written commentary, and for keeping the discussion going. I wasn’t aware of the National Guard options when applying for medical school, and I wound up taking an Army HPSP scholarship and spending 11 years on active duty. Two years later, one of my residents convinced me to visit his Air National Guard unit with the promise of being able to fly as a flight surgeon, and jump with the Search and Rescue unit. I was hooked, and spent the next 12 years as an Air National Guard physician.
The Air National Guard (and to a lesser extent the “Army” National Guard) is one of the best kept secrets of how to serve the country, while maintaining a civilian career (and raising a family). Plus, there are great incentives – student loan payback, and plenty of adventure that you would spent a fortune doing on your own (flying in almost every aircraft available, parachuting, traveling, shooting), and doing it with a great group of Americans. I spent five years on active duty supporting the wars in Iraq and Afghanistan (and unlike the Army side off the Guard, these were voluntary assignments), doing things that I would have never thought possible. For the average Air Guard physician, there were no mandatory active duty deployments, and the typical assignment was 30 (flight surgeon) to 90 (e.g., Surgery, Psych, Anes, Emer Med, IM, FP) days. Plus, unless you are a CV or ortho/neuro surgeon, the active duty pay disparity isn’t that great any more, particularly because Guard/Reserve can now get ridiculously inexpensive health insurance to cover them and their families.
It isn’t for everyone. I know several docs in private practice who came back to a closed office, or to partners who had moved on. But if you are at a VA or a University (or Kaiser), your rights to reemployment are guaranteed by the Federal Government, and most institutions are proud to showcase their physicians and nurses who have served. And it IS the military, but only barely. But when you consider how much control residency programs or hospital medical staffs have over your life, it isn’t any more onerous.
Hi Former ANG Flight Doc,
Thanks for making this reply. I got an update in my email and saw your post and it really put me into some deep thought. I’m currently in the process of applying to medical school and the Naval HPSP scholarship. Your comments, along with this well-written article, seriously make me reconsider my path and that maybe I should try out the ARNG instead. Matt, yourself, and another person on SDN only seem to speak volumes about how positive the experience with the NG is. There does seem to be a huge disparity in regards to positive/negative experience when it comes to the HPSP vs NG folks. Maybe my sample size is too small, but I really like the idea of being able to choose my residency straight out of school without having any other thing (such as a GMO tour) get in the way.
While I think it would be fantastic to be able to serve for a few years as a flight surgeon, dive doc, etc. I am a married non-trad student and I don’t think I want to be returning to residency when I am 35+ years old, commanding a meager salary trying to support a family. This is really the biggest concern for me with the HPSP scholarship.
The upside to the HPSP scholarship is I guess I had more freedom in terms of what school I attend. For example, if I get into a school that I applied to in Washington, DC with a ridiculous cost of living, the HPSP scholarship may give me some financial freedom to attend that school. However, if I decide to not take the scholarship, take out loans and/or go the National Guard route, I see that I will have to aim for and choose less expensive schools in less expensive places to live.
I’m starting to think that choosing a cheaper school (and potentially a less “prestigious” school–whatever that’s worth), combined with NG service may be the best way to go in my situation. I can take advantage of the various benefits (cheap healthcare for family, etc) while in school without taking a stipend (MDSSP or STRAP) so I don’t incur a ridiculous service commitment. I can choose my place of residency straight out of school, and then take advantage of the HPLRP. I won’t be debt free, but the burden of shouldering some debt to be able to control my residency, place of living, serve the country part-time, and command a higher salary and be done with residency training before I’m 40 may be really worth it.
Anyways, thanks guys for all your insight and help. I think by sharing your thoughts you really turn on some light bulbs in the minds of various pre-meds who want to serve their country but also want to maintain a little more control over their lives.
Jonathan, I think that the WCI would urge you to choose the less expensive medical school in a place with a reasonable cost of living. Coming from a less expensive state school, I can honestly say that my fellow medical students feared very well in the match. Board scores are the great equalizer and dedicated study along with use of the USMLE World question bank will make sure you are on a level playing field.
I would advise you to speak to the National Guard/Air Guard physicians/resident physicians within the state that you are applying to medical school. Each state is a little different and experiences may vary. Contact the officer recruiter in the state of interest to facilitate this process.
Also, If you are still considering the Navy, check to see if they still have the HSCP scholarship. 7 years ago, it seemed to be a better deal.
Thank you for the addition to this post. The Air guard is definitely worth consideration. Do you happen to know if the bonus and incentive structure differs at all from the information laid out above? What about the specialties qualifying for incentives? I know that there are subtle differences between the Army Reserve and Army Guard, mainly a difference in the number of specialties meeting incentive criteria and how much is paid per incentive (army guard will pay up to $240,000 in loans, Army Reserve will pay $250,000), but I’m clueless about the Air guard.
Thanks again for your post!
Hi guys, very interesting article. I contacted a national guard recruiter about the program. He immediately referred me to basic training as well as taking the ASVAB. Are either of these required for MDSSP? Should I talk to another recruiter?
Yes. It doesn’t sound like he has a clue about recruiting doctors. I’m not sure about the Guard, but the guys recruiting HPSP students were totally separate from those recruiting Joe Grunt.
You need to look for an AMEDD (Army Medical Department) recruiter. The officer strength manager for your state should be able to assist you. I would just type “officer strength manager” + “the name of your state” into google search. If this doesn’t work, let me know and I’ll try to come up with an alternative solution.
I’m in med school now and seriously looking at taking the approach suggested by the article (no mdssp/no strap/no hplrp). I love that this allows me to test out guard’s impact on my family/schedule without locking me down for 12 years post residency.
Has anyone else done this method? Have any changes been passed that throw a monkey wrench in this?
-Scott
(thanks to Matt and WCI for this article by the way)
Scott:
Glad you found the post informative. I’m not aware of any major changes. I would ask your recruiter for the newest Army National Guard Medical Department (AMEDD) Officer Incentives Policy memorandum. I don’t think they’ve drafted a new one since 2012/2013, but I could be mistaken (last I knew they sent out a few updates to policy, but the memorandum was pending). The medical students that I’ve known have taken STRAP upon joining, but you shouldn’t have to take an incentive and you should just be able to sign up as a medical student. Your military occupational specialty (MOS) should be 00E (student officer). I ran this post by one of the top officials at the National Guard Bureau prior to posting it, so it should all be legitimate (Unless this person missed something).
Thanks for the information. I spoke to a recruiter today who told me that the MDSSP obligation payback starts after graduation and not after residency. My understanding was the MDSSP payback only starts at graduation if you are also signing up for strap. I’ll make sure I read the officer incentive policy memo prior to signing anything as I’m still information gathering right now but does anyone have any clarification on this?
You’re right on the money. Unless they’ve changed something, the recruiter is misinformed.
Here is the exact language from the 2012-13 memmo: The MDSSP participants incur an obligation of 1 year for every 6 months (or part thereof) for which they receive the stipend. This obligation period will be satisfied immediately following program completion, which is residency for medical students and dental school for dental students unless the individual elects to enter into the STRAP program for residency in an eligible specialty. In that event, the original MDSSP contract will be amended.
What about specialties deemed not critically necessary? Would you still be able to get HPLRP if you became a flight surgeon in the NG or Army Reserve?
I have heard that NG + flight surgeon won’t get you HPLRP but Reserve will. If this is true, how does being in the reserve change things (ie yearly time commitment, 90 day BOG, 8 years with 6 active, etc)?
DK:
According to the 2012-2013 Authorized Substitutability List (the most recent policy update) Any Medical Corps officer may be a flight Surgeon except: Psychiatrists (60W), Nuclear Medicine Physicians (60B), Anesthesiologists (60N), Pathologists (60U), Radiologists (61Q/R). I’m not sure why Anesthesiologists are not eligible to be flight surgeons, but I don’t write the policy.
I’m not sure where you received your advice about a flight surgeon not being eligible for incentives in the National Guard, but I think you’re being misled. If I were you, I’d ask for documentation. lets say your an ENT surgeon, or an Orthopod? I’m pretty sure you would easily get a flight surgeon spot.
If your specialty is not on the “Critical Skills Shortage List” and if the National Guard doesn’t want to make an exception to policy. You have a couple options, you can transfer to another branch (Army Reserve, Air Guard, Air Force Command, Navy Guard), or end your commitment. Of the two Radiologists that I knew in the Guard (started as medical students), one transferred to the Air Guard to continue his service and become eligible for incentives and the other ended her commitment after 4 years. She hadn’t accepted any incentives (STRAP, HPLRP, etc.) so the guard let her out of her contract after 4 years (instead of the standard eight year contract). I’m not sure what would have happened had she taken STRAP (what they probably did is put her into the IRR for the last four years of her contract, I’m not entirely sure).
Also do be aware that exceptions can be made to policy. I was told that had I decided to pursue Orthopedic Surgery (what I thought I wanted to do when entering medical school), they would have made a slot for me. Also, I have a couple anesthesiologist friends that now have slots (they tell me that anesthesiologists are now eligible for incentives and slots, but the policy documents haven’t caught up with this advancement).
You’ll need to talk to someone in the reserve to get more specifics on the other policy. They should be the same, but don’t quote me, I haven’t been on that side of the fence.
Hey Matt,
I spoke to my state’s NG AMEDD recruiter today, and he told me that if I join as an MS-1 without taking MDSSP, I won’t be able to take STRAP+HPLRP when I finish my PGY-2. Is this accurate?
I had the impression that I could sign up as a medical student without incentive to “get a feel” for the Guard, and after my PGY-2 is done, incur a new MSO with STRAP+HPLRP (assuming I like the Guard and I’m in an eligible specialty).
If you can help me understand more about this, I’d sincerely appreciate any input.
Also, I am meeting with the recruiter in a week to go over the nitty gritty details. Just to be sure I understand, I can sign up a a medical student and get drill pay+GI bill pay, if I don’t take incentive, right? I understand that the GI Bill is for 36 months. Do I need to be in the Guard or drill “x” number of times before I can take advantage of the GI Bill?
Thanks again for any info, Matt!
Just a correction to my last sentence:
Do I need to be in the Guard -for a certain amount of time- or drill “x” number of times before I can take advantage of the GI Bill?
I can tell you from my personal experience that you do not need to take MDSSP in medical school to be eligible to take the STRAP+HPLRP starting at the conclusion of PGY2. I was not under the MDSSP incentive while in medical school, and I am now receiving STRAP and I am set to receive my first HPLRP payment in July (at the end of my PGY3 year). There is nothing in the incentive memmo (most recently released in 2012) that stipulates the requirement that your NG AMEDD recruiter mentioned.
With regard to the GI bill, please be aware that you will not receive the Post 911 GI bill, but that you will receive the Montgomery GI Bill Select Reserve (MGIB-SR), which provides less remuneration (because you life hasn’t been on the line while serving abroad). You will not need to sign an additional contract (or add time to your original service contract) to receive this benefit because your original 8 year contract (with 6 in active drilling status, and two in the ready reserve) that you sign when joining the guard qualifies you for the MGIB-SR. In order to receive the MGIB-SR you must drill for at least 6 years. On a side note, the 6 years does not start when you begin to receive the MGIB-SR, it’s just a general requirement that you must serve 6 years in drilling status.
Please note that policy does change, so I may be mistaken, but I try to stay abreast of recent advancements and have routinely asked my AMEDD contacts for updated memorandums.
Best of luck,
Matt
Thanks again, Matt!
Somebody on SDN was kind enough to post the various official documentations for the AMEDD incentives.
I noticed under the HPLRP slide of the PPT:
“Serve a year then receive payment -Taxes will be withheld prior to disbursement to lender.”
Do you approximately how much is deducted from the $40k prior to disbursement to the lender? I am just curious for the sake of making some calculations and illustrating a few different scenarios for myself…
Thanks!
That’s a good question and I’m still waiting for the answer. I’ll let you know in July. They have no clue what my tax bracket will be (they haven’t asked me about my moonlighting income), so I’m guessing they’ll just withhold 25%.
Personally, their approach is a little too big brother for me. I’m perfectly capable of setting aside enough money to pay taxes, but I get it, some people can’t do this (large student loans, big families, big lifestyles).
That said, look on the bright side, if they’re taking 25% out for taxes, you might be able to squeeze in one more year of HPLRP, before your loans are paid off (assuming you don’t have 240K in loans). Since HPLRP is a 1 for 1 repayment, and since the government is effectively paying your taxes, it could be a financial boon (assuming you don’t mind an additional year of service for 40,000 or your whatever your loan balance is in the final year of HPLRP).
I received my first HPLRP payment in July, right on time. The National Guard payed $30,000 of my loans and put 10,000 toward taxes.
Hi guys,
This thread has been extremely useful over the past few months while considering my options of either going into the Army NG or Army Reserves. I have met with both recruiters and have explored both of them considerably, basically all that is left is for me to commit to one of them and sign on. A few questions I had that you guys may be able to answer.
A little about myself, I am a 4th year medical student who has recently matched into a 6 year civilian residency. One year surgery internship + 5 years of my residency training in interventional radiology. I am very committed to serving my country and wanted to wait until the end of medical school to join (I basically have the next 3 months off before residency starts to complete the process).
The Army NG recruiter offered me the most compelling offer. Which I thought was the 8 year commitment without taking either the STRAP or HPLRP. Basically giving me the flexibility when I leave residency in 6 years to serve the last two years in the IRR and have the ability to stay on with the military so I choose to without being forced to.
The Army reserves did not offer me this gig at all. Basically they said I would have to take either STRAP or FAP. STRAP basically would be 2 year added time for every year I took. For the 6 years of residency that would be 12 years added time. Making my military career at this point be 18 years (which if it was the case I would stay in for another 2 to make a 20 year pension). Or I could do the FAP program and possible do 3 – 6 years of active duty after residency to fulfill my obligation, rather than the 12 years in the reserves. The reserves just hasn’t seemed as flexible with the programs they were offering me as the guard. I am not sure if I should press this issue or just realize maybe the guard is a better way to go. Also, my specialty is a relatively new field and it is not one that is listed in the Guard so I am assuming I would have to fulfill my last two years in the IRR with the reserves anyways?
Lastly, the reason I did not join the military before medical school was because I enrolled in a combined degree program (MD/PhD) and my tuition was covered by the NIH. My program would not let me join any branch of the military if I accepted the position and tuition reimbursement until I was finished with medical school. That being said I do not have much in the way of loans to payback (<80,000) from college and medical school.
Any advice would be great, I am very excited about either possibility but I really want to make sure I have all my facts straight and the best advice possibility before I commit to anything.
Since you don’t really have loans, I would first consider how you wish to perform your service. Do you want to be a guardsman and mostly have a civilian practice? Do you mostly want to have a military practice?
Personally, if I were you, I would not sign up with the military now and would go ahead and completely your training. Then I would offer to come in on active duty with a 2-4 year commitment. You’ll get a significant signing bonus for doing so. Then, if you love it, you can re-up. If you don’t, you can get out after a couple of years and move on with a civilian career or you can then transition to reserves/guard etc. Chances are very good your life will change in a significant way in the next 6 years. Marriage, kids, different career desires etc. Maintaining flexibility is a good thing. It’s not like you need the money.
Steve, I’ve given your questions a good deal of thought, and I think you should wait until the completion of residency to join the military. I admire your ambition to serve, and to serve as soon as possible, but, in my opinion, the added stressors of drilling while in residency are not worth the sacrifice unless you need to pay off your medical school loans. That said, I believe that the cost to benefit ratio will switch in favor of service after the completion of residency, simply because you will have your full compliment of skills, and will be better able to serve your fellow troops. Of course, you can re-visit the cost to benefit ratio at that time in your life.
More specifically, I caution you against joining now for the following reasons:
1.) Residency can be demanding, and flexible training eligibility is determined by the Unit Commander; a leader that can change from year to year. One year, you may be able to substitute/skip the entire 2 weeks of annual training, the next, you might have to use two of your three or four weeks of vacation (or postpone your training for 2 weeks). The same goes for drill weekends that spill into the week; there is no guarantee that your commander will let you out of drill to complete your residency requirements. I’ve been able to manage because I have a combination of a very understanding program director (former military), and a very flexible Commander (medical)
2.) The service that you can provide while in residency is limited. Although you may be a fully licensed practitioner within your state after the completion of your first year of residency (but not board eligible or board certified), you may not be able to attend Annual Training to put your general medical skills to work (due to residency requirements), or, you might have a reduced role (like that of a medical assistant, if you can’t find an eligible attending to oversee your work in PGY-1). I’ve been on two AT’s and have enjoyed using my general medical knowledge to help the native american population and troops from 6 countries, but I might be an anomaly.
3.) You may not be able to utilize your specialty training in the guard when you complete training. Radiology wasn’t on the list of permissible positions within the Army National Guard in the 2012 incentives memo, and I don’t believe it is on the newest 2015 incentives memo (more on that to follow in the next few weeks). Unless you feel comfortable using your general medical training, please be careful when choosing the guard. I know policy exceptions are made, but please make sure that you will be able to utilize your specialty training in the guard prior to signing up. If you don’t, you may have to call on knowledge from medical school and intern year for the rest of your guard career.
I realize that you might want to join now, to burn of some time on the required eight year commitment, but I don’t think that it is a good idea. If your specialty is desirable to the guard or reserve (which it probably will be; Interventional Radiologists aren’t easy to come by), they can write you a 2 and 6 or 4 and 4 contract. 2 years active, 6 years in individual ready reserve. Also, you may be able to enter as a Major (I’ve seen this on several occasions) because you have added qualifications.
Did I answer your questions? Please let me know if I can be of any additional help.
If you join as an attending, and only have $40,000 in debt – can you do 1 year of HPLRP for $40,000 and then 5 years of $25,000 bonus pay? Or does the bonus pay max out at 3 years/$75,000?
It does say here: http://www.nationalguard.com/healthcare-bonuses-and-loans
>$25,000 per year for a three-year contract
>$20,000 per year for a two-year contract
>And with another three-year commitment, your bonus may be renewable.
After 1 year of HPLRP:
would you be able to get the $25,000 for 5 years or would you only be eligible for 3 years? or would you be forced to do 3 years x $25,000 and then 2 years x $20,000?
You can do the HPLRP for, $40,000 and then take 3 years of bonus paid at 25,000/year. In the past, a medical professional could take repeat bonuses, but that is no longer the case. If you are interested in re-instituting repeat bonuses, please read and then sign the following petition: https://www.change.org/p/assistant-secretary-of-defense-reserve-affairs-authorize-repeat-special-pay-bonus-contracts-for-arng-healthcare-professionals.
Bonuses are taxed at your marginal tax rate (you will have to specify the amount of withholding you will need given your current income situation–you will likely have to use the mypay.dfas.mil system–I have yet to get to this point). Tax is withheld from HPLRP prior to disbursement using some sort of formula that the ARNG has yet to explain to me.