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!
Do you know if people in the ARNG have access to the military’s graduate medical education, either residency or fellowship programs?
I don’t know of anyone who has taken advantage of the military’s graduate medical education. You would have to talk to big army/navy/air-force. My guess is that if any slots remain, you might have a chance. I’m sorry that I can’t be of more help.
I don’t think you would have access. You would certainly have to go onto active duty status during residency (and probably afterward) if you were given access.
Yes, you would have to be on active duty status, but while in on active duty status during residency, unlike in medical school, you will have a 1 for 1 commitment that is paid immediately while serving. Meaning, if you have a 4-year residency, you will complete your service upon the completion of residency, not after. For those who sign-up for the HPSP, they have a 1 for 1 commitment that is paid upon the completion of residency in return for the service of choice (ARMY, NAVY, AIR-FORCE) funding their medical school education. Additionally, they also have a 1 for 1 commitment that is paid immediately while in residency, that is used to fund residency. At least this is my understanding. All that said, I have a feeling it is going to be very difficult to find a slot, because If I am correct, which I think I am, the branch of service would rather fill their slots with HPSP students who are indebted after the completion of residency.
Im a mid career physician, interested out of patriotism and malaise after 20 years of various practice activities, including gov and DOD work. I dont need any tuition repayment, as I had full academic scholarships throughout my education [still chose medicine somehow though 😉 ].
Is there anything for occasional involvement a few weeks per year or weekends/month, no foreign deployment?
I laugh when the military rolls out their financial ‘incentives’, but since I dont qualify even for their best program, tuition repayment, is it a total financial wash? Im not considering it for the money, but I wont do it for free either.
As I understand it, no way to commission in the reserve/guard armed forces without a chance of deployment. Current policy if reserve/guard docs only get sent 90days “boots on ground” but you know how policy can change
You will be eligible for the 25K yearly bonus in addition to your drill pay which will be about 15K per year. But do remember, if you have no prior service, you will have to be in active drilling status for 6 of your 8-year original commitment. As to your part time question, you will have some flexibility with the flexible training policy (see the article above). I am not aware of any non-deployable specialties or situations but that is a question for a more seasoned medical officer recruiter. I would definitely get any non-deployable promise in writing prior to signing up. Good luck.
Non-deployable. Ha ha. Good luck with that. That’s called “civilian.” Seriously though, if there is anything that is truly non-deployable aside from a medical condition, I’d love to hear about it.
Hi Matt, I’m so glad you still check this thread! I am a PGY2 and am getting ready to join the Guard and there are several specifics that I would love to get your thoughts on. Is there any way you might be able to pass your contact info to WCI so that he could give it to me? I would really appreciate it! Thanks!
Jim is welcome to share my information to you. I’m guessing he will facilitate this transfer after moderating this comment. If I need to email him directly, I will. I apologize for the delay, I just started my attending gig and have been very busy.
Email sent to both of you.
Hey Matt,
Thanks for all the helpful advice. I was hoping a could get some more personalized advice though. I will be starting medical school next fall. I am a CPT in the Guard with 11 years of service. Veteran as well. What path do you recommend for getting the most assistance with the least amount of commitment. I am sure I will end up doing 20 years. I know I have some Post 9/11 and state tuition available to me. I appreciate the help!
If you can get accepted in a state the gives free tuition to guard members and then commission as a medical student officer WITHOUT taking the mdssp, you’d get out with no tuition and no obligation by the end of residency.
If you don’t get into a state medical school where tuition is covered for guard members, consider utilizing your Post 9/11 MGIB first. You can also tap into Tri-care Remote for you and your family, get reimbursement for USMLE 1, 2, 3, and collect a drill check. Beyond that, benefits are fairly limited unless you utilize the incentives. Keep in mind that you may have to drop a rank or two when you move to the medical service corps, and will likely start back at captain upon graduation from medical school when you transition into the medical corps. Also, unless policy has changed, once you reach 20 years of service, you will no longer be eligible to take incentives–please check with a current medical recruiter on this. Sorry, I wish I had more for you. The incentive route gets a little more tricky. If you want a long career with the guard, I would take 2 years of STRAP (MS3 and MS4) and 2 years of HPLRP and MDSSP (PGY3 and PGY4). This would put you at 20 years upon the completion of PGY4 and would make your total service commitment 26 years, assuming you have a 4 year residency. I hope this helps.
Thanks for the info, Matt. If I wanted to continue to take HPLRP for an additional 2 or 3 years (possible fellowship), could I? Or do I have to start repaying the MDSSP and STRAP immediately after residency? I know it would add an extra year for every year that I took, but is it ever possible? Thanks!
When you sign the Strap agreement, you obligate yourself until the end of your residency (when you SHOULD graduate). If you do a fellowship, after graduation, you would no longer need STRAP and would begin to take your HPLRP without STRAP. Upon completion of your fellowship or as soon as your loans are extinguished (whichever comes first) you would begin to repay your STRAP obligation.
When joining after PGY2 year is it required to take STRAP along with HPLRP or can HPLRP be taken alone?
I want to limit my commitment to 6/2 and want to just get the $240,000 towards my loans
Also, any tips for finding my AMEDD recruiter? I emailed my local grunt recruiter asking for my state’s(FL) AMEDD recruiter and got no reply
You must take STRAP along with HPLRP if you want HPLRP in residency.
The only way to get the 6 and 2 is to take HPLRP after the completion of residency. You can start to get this in fellowship since you will have completed residency.
Be persistent. Contact other recruiters. Look up your states recruiting and retention battalion on google.
Hey Matt,
I am currently a PGY3 Psychiatry resident considering STRAP and HPLRP starting my 4th yr. Mundane question but is the 40k a year for loan repayment pre or post tax? If its post tax than it most definitely seems worth it as that would basically equal 80k in extra call/Moonlighting Id have to do as an attending. Thanks!
They pull out 10K for taxes and distribute 30K to your loan servicer.
If you are a single resident making less than 51,900, the 10K should cover the additional taxes. If you make more, you may need to set aside additional funds for taxes. (The 2017, 25% tax bracket falls between $37,950 and $91,900; thus, 40K*.25= 10K).
Different scenarios apply to those who file taxes as “married filed jointly” and “head of household”.
Hi Matt,
I was wondering about state taxes for HPLRP payments. Since these payments are recorded by the IRS as taxable income, you get a W-2 showing $40K payment with $10K federal income tax withheld, but what about state income taxes? I would think if you live in a state without income tax you are okay but what if you don’t? Do you have any info on the rules pertaining to state income taxes with HPLRP payments?
Thanks for any thoughts…
You will need to pay state taxes on this income. Since I reside in South Dakota, and since SD has no state tax, I can’t give you much in the way of specifics. My guess is that you should save up enough to cover your marginal state tax rate on the 40K. Sorry, i can’t be more specific.
Good article but it’s a lot to take in. Perhaps someone can help me make sense of it.
My situation is this- I’m 37 and about to start my first year of residency (was an RN before which is why I’m so old). I’m looking into the guard and was planning to start once I graduate but after reading this I’m wondering if I should wait until third year as mentioned. In theory I’d put in the full 20, ending very near 60, then retire on that birthday and float off into the sunset.
Any thoughts on what the best route for someone my age would be? My dad was a military engineer so I’m accustomed to moving; of course on the future though I’d prefer getting sent to Korea or something to going back to Saudi.
The answer depends on how long your residency is, what your residency is in, and how much debt you are in. But generally, I recommend starting the process 1/2 to 1 year prior to the end of your second year of residency. You will have enough to adjust to in that first year of residency and you will likely have insurance (no need for Tricare) and a salary (50+K goes a lot further than $0) to scrape by. It will also give you more time to determine if the National Guard will fit with your future career plans.
Hi Matt,
Thanks for the great article. I’d like to pick your brain and see how you weigh in. I have 15 yrs Active duty, former PA, finishing medical school and beginning EM residency this July with 350K loans. I’d hate to leave 15 yrs on the table and considering finishing out with the Guard. What’s best to make up those 5 years? Still go with your plan to take STRAP during PGY3? Take nothing (or do HPLRP) and join Guard after residency? I look forward to your response. Thanks.
I’m surprised you aren’t considering 5 more years on active duty. I’d give THAT some serious consideration after 15 years of AD service.
CHI, If I were you, I would hold off until after the completion of residency and then take 40K per year in loan repayment. I haven’t done the calculations, but my guess is that the STRAP won’t be of a tremendous benefit for you with your prior service. Also, be warned, there is a cap on incentives after a soldier meets 20 years of credible service and age 60, so you don’t want to re-start the clock too early. The exact language is as follows: “Incentive obligations cannot obligate an officer past his or her mandatory removal date (MRD), without an approved extension, or retirement eligibility date (20 years of credible service and age 60).”
Matt,
Great post! I recently matched FM and have been in the ARNG for 5 years taking MDSSP. I will apply for STRAP and HPLRP. My question is. What do I do with my loans during residency? IBR, PAYE/REPAYE? PSLF is not an option. I had hoped to refinace BUT I am concerned the HPLRP wont repay my refinanced loans.
* I have been in the ARNG for 5 years, MDSSP for 4, prior service 4. Just to clarify.
T. Scott,
Without knowing more about your specifics, it’s hard to give you tailored advice. I had $120,000 in loans when I graduated medical school, so I just let the interest accrue. I figured my investment gains averaged about 5% (real return) so I wasn’t all too concerned about the ramifications of letting my loans suffer the consequences of compound interest. I have since qualified for up to 120K in loan repayment from the VA, so essentially, the VA is picking up the extra interest (private employers may also have a similar offer upon your graduation). One thing I can say, If I were you, I would extinguish undergraduate loans aggressively while in residency since these loans do not qualify for most (including ARNG/VA) loan repayment programs.
Hi Matt,
I hope you still check on this post. I have a question regarding the Medical Student route. That’s what I’m thinking of doing, but I was recently told that if you use the MGIB that it adds an additional 6 years to your 8 year commitment. Can you give any insight into this process. My recruiter isn’t that great and I would l really love clarification. Thanks in advance!
I’m currently a 3rd year student, and just took the oath last month with the ARNG. Will start drilling next month. I’m not prior service or with close relatives in the military, so although I have a strong desire to serve, I don’t have a good practical experience base to inform my long-term decisions about MDSSP/STRAP. For that reason I’ve passed on the MDSSP, and for the next year I’ll use my drill/training time to decide whether or not to extend beyond the standard 6+2 commitment through taking STRAP (or later HPLRP) money. I will say that this post and the comments attached to it have been immensely helpful in making these decisions (thanks Matt!).
You’re welcome. I hope you have a great experience and consider staying in the guard for the long haul.
Best,
K. Trigg,
You were misinformed. MGIB does require 6 years of service, but unless you have prior service, that won’t matter to you. In signing up for the guard, you sign up for a mandatory 8 years (6 in active drilling status, 2 in the individual Ready Reserve), therefore, you will meet this requirement without adding additional time to your service agreement. Additionally, this incentive does not interfere with other medical professional incentives, meaning, it won’t prevent you from applying for MDSSP/STRAP/HPLRP and it won’t add time to the service obligations that stem from these incentives.
K. Trigg,
I am currently a Medical Student Officer in the ARNG. While I can’t speak for the MGIB commitment, I can say that normal recruiters don’t know a thing about AMEDD or how it works. You really need to get in contact with your State AMEDD recruiter. They will know the most current policies and incentives. They will also be able to help you figure out how to get the most benefit with the least amount of commitment. It will be worth the effort.
Hey Daniel,
Thank you so much for the reply. Do you mind me asking how your experience has been thus far and which route you decided to take as far as incentive goes? It’s so hard to get information about it so I appreciate any you have to offer! Thanks again!
Sure! I am prior service, so my approach will be different than yours since I do not have to sign an 8 year service obligation. I will be choosing to take MDSSP for 2 years in Medical School, then STRAP and HPLRP my PG3 and PG4 year (HPLRP is taken within the year it is served). This will require me to serve 6 years after residency. MDSSP and STRAP are both 2 for 1 deals (2 years of service per year of incentive), however, if you take STRAP for the same or greater amount of time as you take MDSSP, the MDSSP obligation changed to a 1 for 1 deal. I received this advice on this website actually from Matt. I confirmed it through my recruiter and he helped me with the ins and outs of the process. I hope this helps.
Hey yall,
I have a few questions! I was recently accepted into an osteopathic school and am currently applying for MDSSP. After turning in the complete application, how long does the decision take? Is there an interview for this as well?
For those that have done this during medical school, did that weekend once a month take away a lot of time from studying? Would you do it again? Any feedback would be awesome!
I had my application packet complete in October 2016, my packet approved in January, interviewed with the federal recognition board in February, and held up my hand in March. My recruiter commented that this was one of the quicker times through the process that he’d seen, but I was pretty prompt about getting things turned around and returned.
My understanding is that what anyone does during drill weekends is fairly unit-dependent. In mine (a medical company within an Infantry Brigade Combat Team) I participate where I can, but seem to have a fair amount of downtime I can use to study. The LTs who are line officers so far seem to have much more managerial responsibility that consumes their time at drills.
My son is an going into his senior year at Brown University in Rhode Island as part of the PLME (BS/MD) program. He is an ROTC 4 year scholarship cadet and just got back from Advanced Camp where he receive an overall E-rating. At Advanced Camp they told the cadets that the Army needs to commission more cadets into Active Duty this year (ie if a Cadet wants Active duty he/she is likely to get it). They also told the cadets that because of the active duty needs that less ed-delays will be approved for their year group. They were not speaking about HPSP or medical school specifically, just ed-delays in general. My son also did not have to take the MCAT, he was approved for med school upon his acceptance to undergrad. So here is the dilemma, the whole reason he chose Brown over West Point and Princeton was for the guaranteed medical school acceptance. He really wanted to go active duty, but we are concerned what ROTC Cadet Command will do. He can only delay one year at Alpert Medical School. If you were him, what would you choose (apply for Ed delay/Active Duty, Guard, or Reserve)? Can my son Caleb speak with you on the phone or connect with you via LinkedIn for a conversation?
I’m not sure how I missed this, but if your son is still seeking guidance, he can connect with me on LinkedIn and we can coordinate communication from there. There are definitely plusses and minuses to each route.
Matt,
First, this was the best article I’ve read on the web. You’ve done a fantastic job; it has been very, very useful. I do have a question. I am an incoming med student and have contacted a few ARNG AMEDD recruiters. I haven’t been able to get a consistent answer on MSO. One speciality branch AMEDD recruiter told me there is no MSO for physicians if no federal incentives are taken… That sounds suspect to me.
1) Could recruiter just be saying there is a minimum 1 year active drilling status with 7 year IRR?
2) If I were to join the NG during my last year of residency (without taking federal incentive) , what is the minimum active drill time before I could IRR?
Thanks so much for your help!
1) Everyone who signs up for the national guard signs a 6 and 2 commitment. 6 years active drilling status, 2 years in IRR (You can choose to continue drill in lieu of IRR). Your recruiter is mistaking your mandatory service obligation with payback time for incentives.
2) You would owe 5 years of active drill time prior to electing IRR. During that 5 years, you could receive 40,000 in loan repayment each year without adding to your commitment.
Thanks so much for your response!!
Matt and James,
Excellent article Matt. I was wondering if you have ever heard of MD/PhD students joining the ARNG and if you had any thoughts on this idea.
Also – The White Coat Investor is a great read.
Best,
Anthony
I’m sorry, but I don’t have any connections with MD/ Ph.D. students in the guard. I think it is a good idea, but I’m not sure if MDSSP would be paid during your Ph.D. years. Since you are in a combined program, I’m guessing you may be able to continue to take MDSSP, but you would want to weight the benefits and drawbacks of an increased commitment. I’m guessing your recruiter will have to take this question up to the National Guard Bureau.
Matt,
2 questions regarding BOLC:
I am an MS3 that joined the Guard as an MS1 but still haven’t and don’t anticipate that I will have time during my MS4 year to complete BOLC. In a reply to comment #16 (back in 2015), you mentioned that one can get a waiver to push BOLC back to after residency.
My questions are:
1. As far as you know, is this still possible, and who would be the person to contact about getting this waiver? Or is there some documentation somewhere that states this?
2. You mentioned you had a buddy that joined as an MS1 and didn’t do BOLC until after Internal Med residency. If I go the same route, do you know if I will still promote to CPT after med school graduation, or will I be a 2LT until BOLC is completed?
Thanks so much as always!!
Jon,
1. As far as I know, it is still possible. I would go through your deputy state surgeon. They should be familiar with the logistics.
2. You should still be promotable to Captian. There was a captain at my BOLC that used a waiver to postpone his BOLC until after the completion of his internal medicine residency.
Of course, all of this will depend on how willing your state is to work with you and how persistent you are in achieving these goals.
Hi, thanks for the info. I am prior service (Navy 9 years) and 49 years old, family med board certified. Got out to raise the kids and now that they are raised and doing well, wanting to come back in the Reserves as I’ve missed the military. Spouse is active duty physician still. I’ve talked to state AMEDD recruiter and trying to still figure out if HPSP credit is given for Armyreserve/ARNG retirement credit (as per Army memorandum and US Code, title 10, chapter 105, subchapter 2126). I know it is being done for the Navy and AF reservists as I’ve talked to them and they were credited. Basically if you were HPSP, completed your AD obligation, come back in the Reserves and are in a critical wartime specialty , you are credited one year from HPSP for each year you do in the Reserves. So it’s a 2 for 1 deal – basically you can have 12 years AD, do 4 years drilling and qualify for a reserve retirement at 60 already. (You are credited 50 points for a “good” year from each HPSP year for each year you do in the Reserves – this is good toward the 20 years needed for a reserve retirement). I am trying to see if Human Resources for the Army Guard is implementing this policy. Do you know if 62B is a critical wartime specialty and if so, is it being approved for HPSP credit? I have reached out to HRC for the Army but haven’t gotten a reply yet. Thank you so much!
See below.
Yes, A 62B (Field Surgeon) is a critical wartime specialty for the Army National Guard and may be filled by all MC with the exception of 60B, 60U, 60W, 61Q, 61R, 61U according to the Reserve Component Critical Skill Shortage List.
As far as HPSP is concerned, my understanding was that you don’t get credit for medical school service until you hit your 20 years (year 1 starts with your internship year). With this in mind, you would need to spend 12 years in drilling status to pick up the medical school years, if you served 8 years post medical school graduation. I am by no means an expert on this, so I could be mistaken or misinformed.
I have 3 years of title 32 service and I received one point for every day on title 32, so I would assume you would get 365 points per year served as an HPSP student once you become eligible to receive that credit.
I would encourage you to continue to press human resources at the ARNG. Generally speaking, ARNG should qualify if Airforce and Navy Reserve qualify. Please let me know what they tell you. This would be good information for prior service professionals.
Thanks for the information. My recruiter has researched it and found it is current policy still and the HPSP years count toward the 20 years, not after reaching 20. Each year is awarded a straight 50 points and only give for each year in the selected reserves. (You submit each year until you get the full 4 years credit, so a 2 for 1 deal).
Attached is the army policy – my recruiter and a couple Army Reserve recruiters didn’t know of the policy – I think it would be a great incentive to get more to stay in the Reserves.
https://mccareer.files.wordpress.com/2018/03/army-policy-guidance-on-reserve-service-credit-for-participation-in-dod-hpsp-and-fap.pdf
One more question- I will be moving in about 3 years due to my husband’s PCS as he is active duty. I have heard that some states don’t offer the physician bonus (retention bonus of 25k) like Hawaii. Are the bonuses for the ARNG state dependent? Do most states offer a bonus for 62B? For that reason, I am thinking of the Army Reserves over ARNG as family medicine seems to be easy to find a billet with the Army Reserves and is a critical specialty.
Thanks so much!
Thank you for the policy! If you want other policies for the guard I can send them to you. Just ask the WCI to connect us.
Bonuses come from Federal Money so, I would see no reason for the state to withhold funding. If I were you I would make sure that your Hawaii contact is sure about the state withholding funds. Perhaps someone wasn’t in a critical wartime shortage position; perhaps they didn’t get their paperwork done; perhaps they were in the guard a few years ago when a cap was placed on the number of years an officer could take a bonus (has since been removed for retention).
You should have no problem finding a 62B position in the Army National Guard. Positions can be double slotted and all field units and medical commands have several slots. Plus, most units have at least one position opening for a doc.
I like the Guard over the Reserves because from what I have observed, there seems to be better coordination and more accountability, due to institutional memory (people stay in AGR positions forever). Of course, my frame of reference comes from the South Dakota National Guard which seems to be a well-oiled machine. I can’t speak for other states.
Thanks again! Glad to hear the bonuses come from NGB. I believe my source was from when they weren’t renewable.
Your source (under # 4) says you get one year max, not much of an incentive.
It says up to four years can be given, if you read the entire part of # 4.
Each year is credited a year as you complete a year in the selected reserves. So my spouse (who only did a 2 year HPSP scholarship) can only get 2 years (getting 4 years credit after 2 years of drilling), while I had a 4 year HPSP scholarship. I know for a fact that Navy reservists who I was on active duty with and who switched to the Reserves have gotten 4 years credit for HPSP (as in they got 2 years credit for each year in the selected reserves, so at the end of four years of drilling, they had 8 “good”
years toward a reserve (not active duty) retirement. I know the Navy Reserves has been doing it per policy , just trying to see if it’s happening with the Guard. But you must be in a critical speciality.
I am currently in the National Guard having joined my second year of med school. I’ve taken 2.5 years of MDSSP and am planning on taking STRAP for a 3 year residency. However, at this time I’m thinking about going into loan repayment assuming I will do PSLF. If that program disappears without my being grandfathered in or I end up not working for a qualifying organization, I would consider using HPLRP. Because I’m tentatively thinking PSLF, I would prefer to do a direct consolidation loan through the government and start making qualifying payments now and also make a few more as a resident and a few less as an attending.
From talking to other residents in my unit who are currently starting to sign up for HPLRP and from the one comment above, my understanding has been that you cannot consolidate your loans through a private company and still get the HPLRP benefit. However, would this still be the case if I did a direct consolidation loan that would still be serviced by the federal government? I would probably only consolidate my loans from med school instead of also including my undergrad loans so that I could still show to the military what amount was for med school.
Bottom line: Any idea if I could still do HPLRP with a direct consolidation loan?
I don’t see why not. Why would they care if you consolidated or not? Not that the military is always logical of course.
Hi Brandon, I am just wanted to ask, if you do MDSSP along with STRAP, does that mean your pay back starts counting even when you are in residency? I think have saw that somewhere. Not only does your MDSSP year goes down by one per STRAP, but you actually start the payback count down during residency instead of when you are an attending. So if I did two years of MDSSP last two years of medical school and two years of STRAP, I would owe a total of 2+4 = 6 years. But if i did a residency that is 4 years, I only have to serve 2 deployable years as an attending in the reserves. It sounds too good to be true; I just want to verify.
Payback will not start until you have completed residency. MDSSP will change from 2-year payback to a 1-year payback for every year taken with Strap. Strap will remain a 2-year payback for every 1 year taken. Strap payback will start after MDSSP has been repaid.
This makes so much more sense now, thank you Matt.
I am a family physician. I separated from USAF in 1/1999 (35yo) with 3.5yrs of AD in USAF under financial assistant program and 2yrs of inactive reserve USAF
I am now 53.5yo and ready to go back. I did not realize that there is an age issue.
I also have Obstructive sleep apnea which is well controlled with CPAP, and arthritis but fully functional.
Please give me some pearls /advise of how can I get eligible to join the National Guard. I also understand that some recruiters are more helpful than others. How do I find one? What type of recruiting bonuses and years of services, etc. calculated that I can expect?
What ranking would I be recommissioned in as I left as a Major for 6mths. Now, I have another 18yrs of experience. thanks
I don’t know if this thread is still active, but I must say this has been amazingly helpful for me to begin to figure out what track is best for me. I am now a rising MSII and have a few questions. Under the section called “Benefits of Joining The Army National Guard” point 10, you talk about state tuition assistance. I go to my state’s only public medical school and the Guard does cover 100% tuition, but does that kick in immediately? I know you have to be on AD at least a year for the GI Bill. Let’s say I complete my packet by July 2018 and swear in in January 2019 or somewhere in the middle of MSII, would I have still paid for the entire MSII year (with loans) or does this too depend on state to state.
Personally, I have about 67K med school debt so far and will more than likely reach 135k by the end of Phase II. State tuition assistance will help me not rack up too much more debt, but I’ll face the cost of living (through loans) unless I do MDSSP for MSIII and MSIV (4 years of duty later). I’m interested in a 5 year residency so would it be smart or even possible to opt out of STRAP until day one of PGY III and do STRAP/HPLRP for PGY III-V? That would pay off all my loans and add 6 years of service post residency while bringing MDSSP payback down to 2 correct? What would I be required to be doing after my 6 years of drilling is done but I am still a resident taking STRAP & MDSSP?
Last question is for someone like me who is joining during medical school esp after the summer between Phase I and Phase II when is the next best opportunity to complete OBLC?
I can’t answer all of your questions, but as someone who joined during medical school and recently completed the initial entry trainings, I can give you some updated information on that. First thing is that completing initial entry training now consists of a 4-week Direct Commission Course (DCC) at Fort Sill in addition to a 4-week Basic Officer Leadership Course (BOLC) at Fort Sam Houston. There’s not a really great time to do these, although fourth year rotation schedules are often flexible enough to squeeze in one. My understanding is that some people are able to attend BOLC, at least, and get credit for it from their schools as an elective (I could not), but this seems to be more difficult if you’re at an MD school, since LCME requirements for rotations are fairly explicit. If you could do DCC between MSII and III, then BOLC during MSIV, that’d probably be the ideal way to go, in my opinion. But that’s assuming you can get commissioned and then onto a class roster expediently.
I would talk to your state educational benefits manager about State Tuition Assistance. Your recruiter should be able to connect you with this person. You really need someone who has the technical knowledge about your state to answer this question.
If you have 135K in debt, you would need to take HPLRP for 4.5 years to extinguish your loan (30K gets applied to principal, 10K goes to taxes). Since you can only take HPLRP one year at a time, you would take it for 4 years and then pay off the remaining 15K on your own (I’m assuming your loans are deferred and not compounding interest). You would have to continue to drill while taking STRAP and HLPRP and would need to continue to drill in the STRAP payback period. If you took STRAP/HLPRP for PGY3-6 (4 years), you would owe 8 years upon the completion of residency. Again, you will need to drill during this period. That said, don’t forget about the flexible drilling policy.
If you join in your PGY 4 year (2 years drilling status in residency) and then take the HPLRP upon completion of residency, you will owe 4 years, in active drilling status, upon the completion of residency, and two years in the ready reserve after those 4 years. Make sense? If you take this option don’t forget to ask about a military deferment.
Right now I am applying to medical school, with the intent on going into psychiatry or diagnostic radiology. All said and done, the cost of schooling will be approximately equal to $220,000 once I am out of medical school. I for some time thought I would shoot for HSPS but after considering the obligations and the risk of military residency, I am almost entirely convinced now to join the guard. This leaves me with various options on when I should enter the guard, but with that I have several questions that I haven’t been able to find the answer to in the posts above. Note: I strive to maximize debt payback while maintaining an end of service obligation at the earliest possible yearly date (to start a new phase of life in the interests of family, career, and hobbies).
Would it be possible for me to begin service at the start of med school (4 years), not take on any benefits, then finish an initial MSO, at the end of residency (2 years active + 2 years IRR) in order to be considered as having prior service? If so, am I correct in thinking that I could then take on HPLRP at a year to year basis (no additional commitment), and get out after I’ve had enough?
This then raises another question I had about HPLRP after reading through your posts that is unclear. Is it possible to sign on to HPLRP for only 3 or 4 years of a $220,000 debt or is it required to sign on until the loan is exhausted? Would anything stop one from using private debt consolidation to fulfill a required payback?
Another option for me would be to wait until PGY-3 to enlist, not have benefits for the first two 2 years (since I am not convinced STRAP is worth the added time for me) and then only take HPLRP for 4 years once I’m an attending. However, in this situation I would end up being in the Guard for up to 3 years longer than the above scenario. What would be the best option for someone who prioritizes the end of date commitment?
Would it be possible for me to begin service at the start of med school (4 years), not take on any benefits, then finish an initial MSO, at the end of residency (2 years active + 2 years IRR) in order to be considered as having prior service? If so, am I correct in thinking that I could then take on HPLRP at a year to year basis (no additional commitment), and get out after I’ve had enough? [Yes, that would be an option, but you would have 6 years of active service (your time in medical school counts), and two years in the RR].
Is it possible to sign on to HPLRP for only 3 or 4 years of a $220,000 debt or is it required to sign on until the loan is exhausted? [You just need to tell the state incentives manager that you want to end your HPLRP repayment and they will discontinue it. I discontinued my HPLRP with about $2,000 left in loans because it didn’t make sense to take another year of HPLRP. I wanted to start my STRAP payback.]
Would anything stop one from using private debt consolidation to fulfill a required payback? [You will have to get into contact with the incentives manager for the National Guard Beruauro (NGB) on this, I would get their answer in email and keep it for your records. My guess is that so long as you can tie the loans back to medical school and a qualified lender you would be okay, but don’t quote me on that.]
Another option for me would be to wait until PGY-3 to enlist, not have benefits for the first two 2 years (since I am not convinced STRAP is worth the added time for me) and then only take HPLRP for 4 years once I’m an attending. However, in this situation, I would end up being in the Guard for up to 3 years longer than the above scenario. What would be the best option for someone who prioritizes the end of date commitment? {Option one, but my hope is that you find you really enjoy the Guard and find fulfillment and a sense of duty in continued service.]
Hey Matt!
I was wondering if I could get in contact with you, personally, to ask specific questions about the USD and the SD National Guard? Your advice on this forum has been extremely helpful for me over the past 4-5 years as I’ve journeyed through med school and the Guard.
Is there a way I can privately share my email with you for correspondence?
I appreciate your help as always.
Best regards,
Jonathan
Hey, Jonathan, I’d be happy to talk to you. The WCI has connected me with commenters in the past. Let’s give his staff a while to connect us. If they don’t connect us, you can always message me through Linked-In.
The staff that reads these comments and connects you is me. I’ve sent you both an email from Maui.
I don’t know how you do it all. Much appreciated!
Oh it’s not bad. We surf one day, then SCUBA dive he next, then go canyoneering, then SCUBA dive again. 🙂
Matt,
I’m a prior service active duty Army aviation officer (CH-47F pilot), with 7 years of service, who decided to get out and go to medical school at Kansas University Medical Center in Kansas City, Kansas. Currently, I reside in the IRR, and I am in my second year of medical school.
Do you accrue time in service (towards your 20 years) as a E67? Can you remain an E67 throughout residency without taking any incentives?
Would it be smart/possible for me to sign up as an E67 without taking any incentives, so I can just get a feel for what the guard is like before making a bigger commitment?
I did read your prior service paragraph in your original post, but I’m unclear as how I would ensure that I don’t have sign that 6/2 contract.
I have the GI bill (80%), so I am already in a good spot, but obviously looking to make it better if possible. I would imagine that I’ll have approximately 80k of debt (due to living expenses – not tuition) after medical school. I would love to chat with you more in depth, and I did look you up on linkedin but no luck.
-Ryan
Yes, you accrue time in service as an E67. I’m not entirely sure what slot I was in as a resident, but I didn’t take any incentives until the completion of my second year and wasn’t pressured to do so to stay in.
I think it would be smart to sign up to see what it is like before taking incentives.
A 6/2 contract is just required if you have no prior service. The recruiter just won’t make you sign any paperwork requiring that term of service. If they try to, tell them you are not interested and have them process you without.
The WCI can connect us through email if he is able and willing.
Best,