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!
Also, is HPLRP/STRAP/Bonus pay tax free or considered income?
This thread has been great. I am also thinking of joining the guard in medical school. I am wondering how is national guard like for physicians? How much does it limit job search after graduation? This seems to be the major downside of guard for other careers; employers find a way around hiring guard members. Does this apply to physicians as well?
I’m glad you enjoyed the post. I have really enjoyed my time in the national guard. I always tell people it’s one of the best decisions I’ve ever made. My job search hasn’t been limited at all and I haven’t noticed any type of discrimination. If anything, employers are interested in the leadership experience I’ve gained with the National Guard.
Hi Matt! Thanks again for all your useful information. I going through the final processes here and am happy to say that I will be joining the NG as early as next month before I start medical school!
Quick question for you: How does the Annual Training (AT) work during medical school? Can medical school count towards your AT or did you usually go somewhere during the school break to do AT?
Also, do you still get paid for drill when you use flexi/split training? I heard yes and no on this depending whom I talked to, so I wasn’t sure.
Thanks again!
You only get paid for drill when you show up. The ability to do the flex training is at the discretion of your CO.
Annual training (at least in my state) is basically waived while I’m in school.
Congratulations Jonathan! I hope you have a long and enjoyable career with the National Guard!
You must work with your unit commander to get out of Annual Training. Sometime in January or February, he or she will have you write a letter requesting leave from AT. I never had any problem with getting leave from AT.
You might be able to find something that qualifies for credit, but you’ll have to talk with your commanding officer as he or she will have the authority to grant your requests.
Yes, you still get paid when split/flex training. Again, you must work with your commander to secure these options.
I must say that recently, with the Federal budget constraints, it has been harder and harder to secure split training opportunities. In addition my state basically stopped funding the $2,500 for CME travel and expenses. I believe that this CME funding will return and along with it will come more flexibility with split training (my state made a mistake in last years budget and it seems as if they have been trying to recoup funds out of this years budget to pay a loan back).
Thanks for the replies! I’m definitely looking forward to this new chapter in my life.
Another question if I may: When did you end up doing your officer training at Fort Sam Houston? Or, when would you recommend I do it? Between 1st and 2nd year or just do it after graduation…?
Am I eligible for the Montgomery GI Bill Select Reserve without this training?
Thanks again for all your help!
It worked best for me to complete my BOLC training between my first and second year because we had a summer break. I’ve known others who have waited until their fourth year when they have elective time and increased vacation.
I think it is nice to get this training out of the way as soon as possible for the following reasons: One, If you go to BOLC between your first two years, you’ll be completing the training with members of the Active Duty HPSP scholarship program. It’s kind of nice to get to socialize with military medical professionals at your level of training. Two, you become eligible for the MGIB-SR only after completing BOLC.
As a drawback, if you complete BOLC between your first and second year, you may give up opportunities to shadow medical professionals in your area. We had a program called “First Steps” that basically payed us $3000 to shadow physicians, in various specialties, over a ten week period, between first and second year.
Of course, complete OBLC in your fourth year also has some drawbacks. You may find yourself in a crunch if you are planning on interviewing for a very competitive specialty–I.e. you may have to use most of your vacation weeks for interviewing.
Hello all!
I ran across this thread it is extremely helpful.
I was offered a job at a FQHC. They told me that I could apply for loan repayment through the National Health Service Corps (NHSC). Does anyone know if I can take HPLRP and NHSC loan repayment funds simultaneously? Or can you recommend a contact who I can get an answer from? Not sure if I should ask the guard, NHSC or Dept of Education.
John, I’m sorry for the delayed response. I’ve thought about looking into this in the past. The national guard will more than pay off my loans, but it never hurts to pay them off early. I don’t remember seeing anything in the loan repayment contract that would preclude you from taking both. Google “DD 2475” and “AGREEMENT HEALTH PROFESSIONS LOAN REPAYMENT (HPLR)” for more information on the program. You should be able to find what you need.
Hi Matt,
Quick question for you. I will be applying to medical school in the 2016 application cycle and have a competitive profile (3.8+ CUM, 3.9+ BCPM 38+ MCAT, research experience, work experience as a non-trad). I am seeking assistance regarding a NG 00E67 contract.
Assuming that I receive acceptance from a state school by March 2017, is there a way that I can complete BOLC I and II before I start medical school to draw the $350 a month via the Montgomery GI Bill? In addition, I intend on pursuing a career in general surgery with a possible vascular or trauma fellowship. Are general surgeons on the critical skills shortage list?
Thanks,
Gram
see below.
General surgeons are generally HIGHLY desirable to the military. So I’d expect them to always be on lists like that. However, I would NOT assume that you will still want to do general surgery 5 years from now or trauma 10 years from now.
You are eligible to join the guard in a 00367 slot as soon as you have a letter of acceptance from a medical school. If this occurs early enough, you could potentially complete phase 1 BOLC (online) and Phase 2 BOLC (in person) training prior to the start of your medical school career.
As long as you go through general surgery you’ll be on the wartime shortage list. Fellowship training won’t change your eligibility. As a matter-of-fact, HPLRP payback starts upon completion of your surgery residency, so you don’t have to take STRAP in fellowship to keep the HPLRP payments rolling.
I joined as an “ASR” in 2009, currently have 2 years left. I’m eligible for IRR next month, but I like my unit and like the 600$/mo. I’m a PGY-3 in Dermatology, my AOC is 62B, I have 1 more year of residency and will likely do a 1 year fellowship which will end in 06/2018.
As far as options at this point, what would you recommend to get maximum return for minimal time? I have about 80k in student loans.
My question is:
1. If I do HPLRP + STRAP for the next 1-2 years, will my HPLRP followed by STRAP payback start immediately or will my payback begin in 2 years when my current contract is up?
I’ve already spoken to the state and would be eligible for STRAP/HPLRP with my current specialty.
Thanks for your help!
AA: I still say joining the guard was the best decision I have ever made, and it sounds like it’s right up there for you too. We sure lucked out with the “ASR” program.
I would suggest that you take STRAP and HPLRP Starting on July 1, 2016. You should be able to begin the paperwork for this prior to the completion PGY3 (get the ball rolling on the 1st of March, 2016) and, if all goes well, you should receive your first HPLRP installment in July 2017 (you get the payment at the end of the contracted year, therefore, if your contract starts on July 1, 2016, you will be payed on July 1, 2017). As an added bonus, you will get STRAP payments every month in PGY4.
Please be aware that you do not need to take STRAP while in fellowship to be eligible for the HPRLP. You may be given the option to take STRAP in your fellowship, but I would advise against it. It just doesn’t make sense from a financial standpoint.
Since $30,000 is applied to your loans yearly and 10,000 is withheld for taxes each year, it will take three years to pay off your loans. Year 1: 80,000 + (80,000 * 6.8%) – 30,000 = 55,440; Year 2: 55,440 + (55,440 * 6.8%) – 30,000 = 25,440; Year 3: 25,440 + (25,440 * 6.8%) – 30,000 = -2,381 (you will get a benefit of $37,619 in the final year because you won’t have enough left in loans to get the full 40,000, that is, unless you let your loans accrue interest in the 8 months between now and July 1st, 2016).
Completing the process in this manner will allow you to start your loan repayment a year early and will not extend your obligation. By the time your loans are payed off, your STRAP payback will be complete (STRAP payback starts upon completion of residency, not fellowship). Given your situation, you will not owe any more time after July 1, 2019. You’ll be one year out of fellowship without loans and with a very good salary. GOOD WORK. At that time, you can decide if you want to enrol for three more years to collect the $25,000 bonus.
Good luck in dermatology. Feel free to send any patients with psychogenic dermatitis my way.
Thanks for the detailed response! This post has been extremely informative.
Yeah ASR was truly the best decision I’ve ever made. I just have one more question for clarification.
So with my current 8 year comitment ending in 11/2017. I finish residency 07/2017. Would I start repayment for STRAP in 07/2017 or would it start when my current contract is up in 11/2017?
I believe I answered your question, below. Please let me know if I have confused the matter at all.
Best,
Just got email from state: So they say that STRAP payback will not start until I close HPLRP contract. This would mean if I took STRAP/HPLRP for 2016-2017, HPLRP for 2017-2019. My STRAP payback would be from 2019-2021. Is my state wrong. Basically I can’t get HPLRP during STRAP repayment immediately after residency. What’s your thoughts?
Please see my post below (october 8 @ 7AM).
Option 1: If you take STRAP and HPLRP together you will Pay off your student loans one year post fellowship and you will also have around $25,000 more in gross earnings in your PGY4 year. You will also owe a total of four years of service after the completion of Residency (Strap payback–2 years in your case–will begin upon the completion of HPLRP–which for you will take 3 years, starting at the beginning of your PGY4 year and ending two years after the completion of residency).
Option 2: If you take HPRLP after the completion of residency, you will owe one year of service for each year of HPLRP you decide to take. You can get out of the guards at any time after the completion of your yearly contract. Just be certain to pay off your loans prior to electing to exit the guard because technically the contract states that it is in force until all loans have been paid in full. After your loans are all payed off (which will be 3 years after the completion of residency) you can elect to take the bonus should you want to stay in the guard. Remember, you only get 25,000/year if you elect to take the bonus for three years. If you elect to take it in one year allotments, you only get $15,000.
Option one will give you more cash in residency at a lower tax bracket. Option two will give you more flexibility. It depends on what you prefer. If you think that guards might be too much to handle after you get into practice, pick Option 2, if not, go with option 1.
Your state is correct. I made a mistake last night, I’m sorry. I guess that’s one reason not to reply to emails late at night. I’ll have to think about your situation again, but it now seems that it might be best to take HPLRP on completion of residency.
So I’m also being told with HPLRP I’m only eligible for 2 years.
Year one… $40K… $30K after tax
Year two… $40K…$30K after tax
I’m not eligible for a 3rd year because the guard sees there contribution in pretax dollars, not post tax. I would still walk away with 20k in loans.
Are you familiar with this pitfall? Thanks again Matt.
I’m almost certain that whoever gave you that information is misinformed.
Each year you must submit your NSLDS information so that your loans will be paid. therefore,the $5,000 of accrued interest and the $25,000 worth of loans which weren’t paid because the National Guard sent taxes to the IRS and because you let interest accrue, should be paid. I say this because the interest and unpaid loan balance are a product of your medical student loan debt and this debt will be appropriately identified on the NSLDS printout. Please see the following Powerpoint presentation for more information:
https://drive.google.com/file/d/0BwJlLaYU2l8rYjNiNDJjYzUtYTZlNy00YjhiLWE2MzMtODMzZmJiNjAwMTlm/view?usp=sharing
If they can give you documentation which proves otherwise, please let me know. Don’t accept conjecture.
This would be post residency of course. I’ve eliminated the idea of doing STRAP. I’m better off doing HPLRP on a year to year basis, followed by Specialty pay if I decide to make a longer commitment.
Hey Matt! Do you know if HPLRP will still reimburse if I refinance my medical school loans with DRB?
I know you can’t consolidate your loans so I’m guessing you can’t use DRB. I thought about it briefly, and then determined that the potential savings didn’t justify the risk.
So the AMEDD incentive policy allows you to consolidate as long as your loans stay federal:
(d) Consolidated educational loans are eligible for repayment. The individual must provide evidence showing the portion of the loan consolidation that was used to obtain the qualifying degree. This will be the only portion of the loan eligible for repayment.
My loans are reconsolidated with NELNET and show on the nslds.ed.gov website, therefore they are eligible for loan repayment. You are correct I cannot refinance with a private bank and remain eligible (would be taken of nslds.ed.gov website).
I’m leaning towards STRAP+HPLRP during PGY-4, then 2 years of HPLRP. Believe it or not, from my calculations the STRAP/HPLRP vs HPLRP ONLY after residency for 4 years both have me ending my term in 2021, but the STRAP option has a slightly smaller payoff, this is due to 3 extra years of interest (PGY-4, 3rd and 4th year after residency). Another benefit of STRAP/HPLRP is that my loans are paid off 2 years earlier than HPLRP ONLY, whereas HPLRP ONLY allows more freedom to leave. At this time I plan to make the ANG a career so STRAP+HPLRP seems favorable. Hope all is well and thanks again for the advice!
Hi Matt,
Thank you very much for the article, it has been very helpful. I have been considering the NG, however, was wondering how the decision to pursue fellowship would be affect. I am a second year IM resident right now and so was considering joining starting the beginning of my PGY 3 and taking the STRAP and HPLRP. My question is regarding fellowship and if I can be deployed during fellowship and if these benefits are still available during fellowship. The way I am understanding it right now, it seems like I would get STRAP during my PGY 3 year of IM (and owe 2 years for this), and as I have more than 240K in medical school debt, receive the HPLRP from PGY 3,4,5,6 and 2 years during practice (which would be payed back the years I receive it) and begin paying back my STRAP commitment during years 3 and 4 of practice. My total commitment would be 8 years. Just wondering if I am understanding this correctly and if I will have to take the STRAP during fellowship and if I can still get the HPLRP during fellowship. Thank you!
From Matt via email: (Not sure why this didn’t post):
Angie: I’m glad I have been of help. I don’t think you need to be terribly concerned about being deployed while in fellowship. If you decide to take STRAP/HPLRP while in fellowship you should definitely have no worries about deployment. If you don’t, you should talk with the commander in the area where you plan on doing your fellowship. He or she may be able to provide you additional deployment protection. Bottom line: given what I know, and have experienced, I don’t believe that the Guard will interrupt your training.
You understand your payback as I understand it. Again, just be aware that you can take STRAP with HPLRP while in fellowship if approved. This would add a significant amount of payback, but it might give you added protection against deployment (which I don’t really think you’ll have to worry about). A cardiologist (or other specialist) is valuable enough to grant some leeway in deployment cycles.
How long does it usually take for the application to be processed? My recruiter gave everything in for the MDSSP scholarship I think October 22 and wanted to have an idea. Do they accept most medical students who apply? I had a GPA of 3.88 undergraduate and the old MCAT of 32, and I am currently getting all A’s in medical school 1st year. I am just wondering about when do the board announce their decisions.
You’ll need to wait until the next DA board selection process. If things haven’t changed, the board should report their findings in November. Check out this link for more information: https://www.youtube.com/watch?v=A4uJuwh40A0&feature=youtu.be
I wouldn’t worry at all about being selected with an undergraduate GPA of 3.88 and an MCAT of 32. You’ll be fine.
I am a second year biochemistry major with a 4 year Army ROTC scholarship. Although my acceptance to medical school looks promising, I know it is not guaranteed on my first try. I was wondering if the National Guard would be a good option? Would it allow me to fulfill this goal of reapplying to medical school? Could I be pulled from medical school to serve? Is medical school and Guard duty compatible? Is there a contact with the National Guard I could discuss these issues with. Thank you , Jimmy
I would wait until you get your letter of acceptance. If you cannot wait, due to ROTC, I would consider joining early, just know that if you are not protected from deployment until you have been commissioned into the medical service corps 00E (medical student) and you cannot be commissioned until you have a medical school acceptance letter. You will also have to complete appropriate military education for the job that you sign on for (i.e. medic) which could delay matriculation into medical school. You can put your information in this website and someone should contact you (http://www.nationalguard.com/amedd). Your other questions are answered in the post, please look it over more thoroughly.
Best,
I know I read in your post that the guard does not deploy medical students. I had been told otherwise by an Army Health Care recruiter. I guess I was looking for clarification on this issue.
I appreciate your concern, because I had similar concerns when I was an your shoes, but think about it this way: unless you sign on for a different MOS prior to medical school, and complete applicable training for that MOS, you will have NO transferable skills. I hate to say this, but a medical degree is pretty much useless until you complete at least one year of graduate medical education (i.e. residency), because no state (or even the federal government–they require that you have a full unrestricted license in any state before they will credential you) will license you to practise medicine.
Could the Army pull you from medical school, send you to a different school to train you as a medic or some other MOS, and then send you overseas, sure, I suppose they could. Is that going to happen? I don’t think so.
What would you say is the best course of action for someone in my situation? In other words, what is the best course of action for an ROTC cadet wishing to reapply to medical school ASAP? Is there a situation that would allow me to serve for the time being and then become a medical student with no threat of deployment?
Comments lost due to some technical issues while working on the site:
From AA:
Thanks for the detailed response! This post has been extremely informative.
Yeah ASR was truly the best decision I’ve ever made. I just have one more question for clarification.
So with my current 8 year comitment ending in 11/2017. I finish residency 07/2017. Would I start repayment for STRAP in 07/2017 or would it start when my current contract is up in 11/2017?
From AA
Just got email from state: So they say that STRAP payback will not start until I close HPLRP contract. This would mean if I took STRAP/HPLRP for 2016-2017, HPLRP for 2017-2019. My STRAP payback would be from 2019-2021. Is my state wrong. Basically I can’t get HPLRP during STRAP repayment immediately after residency. What’s your thoughts?
From Matt:
Your state is correct. I made a mistake last night, I’m sorry. I guess that’s one reason not to reply to emails late at night. I’ll have to think about your situation again, but it now seems that it might be best to take HPLRP on completion of residency.
Given the late publication of this question and answer dialogue, I’m not sure if something is unresolved. Is there still an outstanding question?
Never mind Matt. I got confused while doing some tech stuff. Those were posted weeks ago.
Hey, I am going to be a first year medical student and am interested in joining the guard. I am going to go to medical school in illinois and as of right now, do not have an acceptance to a state school, only a couple private ones. Is there any assistance to kids at private schools?
The incentives stay the same. Please read the post for details.
Hi Matt,
I have a lot of questions that I hope you can answer. I reviewed a Critical Skills/Wartime Shortage List, and I don’t think I completely understand what I’ve read. Is Orthopedics on the list (directly or by substitution)? Would I have to become a Flight Surgeon or be assigned to a Field Surgeon position to be eligible for Specialty Pay (Bonuses) STRAP, HPLRP? Am I allowed to attend the FS course as a resident? What AOCs are available to Orthopods? Do NG Orthopods perform surgery on deployment as members of a Surgical Team or do they run general/medical clinic?
Hey, Kid. Orthopedics is not on the list, but I’ve been told that it can be substituted. The lawyer that helped to write the policy told me that the Guard would love to have an orthopedist and would make exceptions if needed. You will likely not have to go to flight training school. Your trauma management training alone will be invaluable. You should qualify for bonuses and other incentives and they have an AOC for an orthopedist, its just not listed on the official wartime shortage list. While they can put anyone in a general med/clinic (and have), my guess is your skills will be so valuable that they’ll utilize you as a part of their orthopedic team. You will likely need to talk with the National Guard Personnel Program Manager for more detail. I don’t feel comfortable passing on her information through this post, so I’ll ask the WCI to pass on my email to you. Good luck.
Awesome article guys. Im a second year medical student considering joining the National Guard. If I join before residency, will i be allowed to participate in the military match?
Thanks.
Joe, I’ve had fellow medical students in the National Guard do rotations (externships) at an active duty facility, but I’m not aware of anyone who has participated in the military match. I’ve been told it can be done, but that may just be hearsay. You will need to talk with someone in the active duty side of the military for an answer to your question–preferably someone who works with the military match.
I don’t know either. Haven’t heard of it. Of course, it’s far more common for someone required to go through the military match to watch to match civilian than vice versa.
Hey Matt, a couple questions for you if you have the time:
–I read on SDN that Anesthesiology is now one of the CWSL eligible specialties but that regs just haven’t been updated to reflect that, yet. Do you know if there is any validity to this claim? I’m wondering because it’s something I’m interested in doing but am not sure how this will affect my Guard career should I choose to enter an Anesthesiology residency…
–Also, in my MedDet unit, rumor is that we will have to start drilling every month, because somebody in command is not OK with us not showing up for drill and still getting paid. Up to this point we’ve had awesome flexibility drilling every other month and collecting drill pay regardless. Is the minimum 6 months drilling for med students just a policy that is State-dependent? Do you think we should contact our State Surgeon (who is an EM doc that seems to really advocate for us) if this is something that might be implemented? Besides interfering with major exams, I can’t see how attending every drill is feasible with 3rd year rotations…
Anyways, maybe you have more insight than me on some of these things so I wanted to ask–thanks always for your help on these topics!!
Hey, Jonathan, Anesthesiology is now eligible for incentives. They made it eligible the year after I graduated (2013). I know this because an underclassmen at the Sanford School of Medicine who was also in the guards, went into Anesthesiology and was eligible for incentives.
Your drill policy is up to your commander. I would talk with them first, and if they aren’t receptive, I would talk to your state surgeon. My guess is that your commander is getting pushback from the battalion. The flexible training policy is as outlined here: https://drive.google.com/file/d/0BwJlLaYU2l8rMnBlR3M4NXFYcnc/view?usp=sharing. As far as I know, it hasn’t been updated since 2013 (I routinely check for updates).
Jon,
Let me know when you’ve finished downloading the policy so I can disable the link?
Thank you,
Hey Matt!! Sorry for the delayed reply–thanks for the link!! I have it now so go ahead and disable it.
Sounds like solid advice. I will share this with my fellow med student LTs and see what become of it.
Best regards,
Jonathan
Hey Matt,
Just another quick Q: is Psychiatry eligible for incentive as well?
Recruiter told me “No” but I figure that’s probably outdated info as well?
Thanks for your help!
Jonathan
Hey, Jonathan, please see my response below.
Matt–
I’m sorry — can I have the link to download that flex training policy memo one more time? I hate to bother you but I have fellow Guard members / senior officers asking for it and I can’t seem to figure out where I kept it. Thanks so much.
Sure can: https://drive.google.com/file/d/0BwJlLaYU2l8rMnBlR3M4NXFYcnc/view?usp=sharing
Got it. Thanks a million, Matt!
Yes, psychiatry is eligible. I’m now in my second year of recieving STRAP and HPLRP and I am a 4th year psychiatry resident. Good luck! Psychiatry is a great fit with the guards!
I’m having trouble getting my local office to recognize retirement points for the online BOLC phase1. Is that not something we are supposed to get points for? if so, does anyone know a document or form that I can direct command to look at? – thanks
Phase one can be used for constructive credit for split training, if your state approves of this use. Unfortunately they do not have to give you retirement credit for online coursework. That said, you could work with your state to see if the following Continuing Education Memorandum would allow them to classify phase 1 BOLC as Continuing Health Education (https://drive.google.com/file/d/0BwJlLaYU2l8rWUh6SHVYc3lZLVU/view?usp=sharing) which can be substituted for retirement points. I will be disabling this link in a couple of days, so please let me know when you download it?
Hey Matt, I don’t know if this thread is still checked but I have some questions so I figured I would at least try. Like everyone else has said, thank you for making this post as well as all of your followup comments, they have been very helpful. I have a unique situation and want to see how things will differ for me. I am a medical student at the University of Missouri – Kansas City which has a 6-year medical program that I got into directly out of high school. This program has no MCAT, and no further application process. Once accepted as long as you keep your GPA you will graduate with an MD. I had originally thought I would do the HPSP because I wanted to do military service as well as medicine. After reading this article, however, I think the guard is the best fit for what I am looking for due to choosing your residency, where you work, family, etc.
What I am wondering is how would my commitment/MDSSP/STRAP and all of that would differ with this 6-year program? What do you think would be the best way to go about serving while maximizing the benefits? Right now, if I go directly through school with all loans, I will end up ~ $284,000 in debt, before interest of course. All though that is daunting now, I know I can pay it off in the future, but I have the desire to serve so why not do that and help cut down on that number. I’m sorry if some of what I said doesn’t make sense, I will clarify anything if needed.
Thanks,
Jacob
Jacob, I would join right away to take advantage of insurance benefits, the regular drill paycheck, and to start chipping away at your original 8-year commitment. If you really like the guards, consider taking STRAP in your 5th and 6th year of Medical School, if you’re not sure, wait until after completion of your PGY2 year (which will also be the end of your original 8 year commitment) to take the MDSSP and HPLRP (you could go into the individual Ready Reserve for the first two years of residency, prior to taking the MDSSP and HPLRP, if you don’t want to deal with the hassles of drilling during intern year and PGY2). If you are still unsure, or if you don’t want to deal with drill weekends during residency, get out of the guards after 8 years (at the completion of your PGY2 year) and re-join upon completion of residency for the HPLRP. At that time you will have a better understanding of how the HPLRP will help you to meet your financial goals. If you’re an orthopedic surgeon by then, you can probably do without the loan repayment, if your a psychiatrist, you will probably gladly take the additional 240K.
Thanks Matt. I am looking at the AMEDD National Guard page and the requirements to qualify. One is “Be 21 years of age” and another is “Have completed an accredited qualifying degree program” neither of which do I meet. The program has you work on your BA and MD at the same time so you end up actually fully completing your MD in the 4th year of the 6 years. Does this mean that I will have to wait until both requirements are met in my 4th year, or would I maybe have an exception made now? Or maybe next fall when I am 21 I could have just one exception made? Thanks for your help.
All you really need is an acceptance letter into medical school. That alone allows you to be commissioned as a medical student officer (00E67). I’m guessing the authors of the AMEDD webpage didn’t have the forethought to address the concerns of people in your position, and they may be slightly misinformed (I see no reason why you can’t be accepted prior to the age of 21). I could be wrong, but I think I’m right. Your best best would be to contact the officer recruiter in your state and to have them do some serious digging. Don’t let them tell you that you are not eligible unless they can prove it to you in writing–a memorandum, contract or other official documents. Good luck!
Hi Matt,
Thank you for the article, very informative.
One of my big hesitations, financially, about military service at this point in life is the financial risk it might pose to my family (wife/child). Most life insurance plans have an automatic “war” exclusion, and the standard military life insurance ($400K) doesn’t even begin to cover what the loss of my income would be to them. I know that physicians are some of the safest folks in war zones, but I also trained with a surgeon who was subsequently killed in Iraq, so it happens.
I guess I just wonder if you have any thoughts on that element to it, and how other physicians handle that aspect (or just other military personnel generally – doctors’ salary aside, $400K really isn’t much life insurance for *anyone* with a young family these days). It’s one thing to put your own life on the line, but when you’re talking about not just leaving your family, but leaving them without adequate financial provision, that’s kind of a tough sell. Your thoughts?
There are definitely places that sell insurance with no war exlusion. (Just did some googling so no vouching for price or rates….I’ll leave that to WCI)
I’m not sure I’ve seen one without a war exclusion. That would be nice to see a list of companies that offer it, but the bottom line is you might as well put that independent agent to work. You’re paying him enough, let him be the birddog.
Serving in the military is less risky than most of my hobbies. It does make service less desirable though. But that aspect is small fry compared to being told where to live and being deployed away from your family for 4-15 months at a time in my view.
Sorry for my delay in responding. At this point in my life, I don’t need life insurance, so I haven’t really thought that question through. That said, you bring up a very interesting point. One that a person with a family should consider.
I wish I could tell you how many physicians have been seriously injured or killed while at war over the last 10 years, but I can’t without doing more research than I am willing to do at this time. My guess is that of the physicians active in the guard over the last 10 years, more have been killed or injured in car accidents than as a byproduct of war. Therefore I would estimate your likelihood of dying overseas to be very minimal, that said, based on your own account, it does happen.
My advice would be to have a life insurance broker look for a policy for you. I’ve had good luck in securing Disability insurance with Larry Keller, who also posts on this site, so you might want to try him for life insurance. If you find anything, please respond to this post. If I don’t hear from you, I’ll try to give an update when I need to search for life insurance.
In addressing the WCI’s second comment, the deployment is limited to “90 days boots on ground” with in-proccessing and out-proccesing time on either side that can generally take up to 1-2 weeks. You are also not told where to live and can transfer guard units if your civilian job requires you to move.
Good luck in your search.