For Prospective Doctors: HPSP vs USUHS?

[franknd]

At first glance I'm having a hard time figuring out why anyone would choose USUHS over HPSP in order to fund medical school. USUHS appears to require a longer service obligation, and as far as I can tell, the only benefit is being on active duty while in school, but that's mitigated by the generous stipend and 45-day annual ADT that HPSP students get. In addition, if the Air Force information on-line remains accurate, it seems to me that being awarded an HPSP (at least from the Air Force) is easier than being accepted to USUHS.

What am I missing?

 

[Capt MJ]

At first glance I'm having a hard time figuring out why anyone would choose USUHS over HPSP in order to fund medical school. USUHS appears to require a longer service obligation, and as far as I can tell, the only benefit is being on active duty while in school, but that's mitigated by the generous stipend and 45-day annual ADT that HPSP students get. In addition, if the Air Force information on-line remains accurate, it seems to me that being awarded an HPSP (at least from the Air Force) is easier than being accepted to USUHS.

What am I missing?

For people already on AD coming in from a SA or other AD, it provides seamless continuity of benefits - especially untaxed BAH in the DC area, Commissary and Exchange benefits, and no-cost TRICARE healthcare. And - if you have a family or plan to start one, that continuity of benefits is extra important.

We had a USNA sponsor son get into several fine medical schools, but he elected to go to USUHS, as he was getting married in August after graduation, and they planned to start their family within a year. He was able to immediately start his TSP (govt 401K) with his earned income as an O-1, got his single then with-dependents BAH housing allowance at DC-area rate, had full medical and dental coverage for wife and the 2 kids they had while he was at USUHS. He loved the access to senior military doctors and their career mentoring, opportunity to get time on USNS COMFORT, exposure to Johns Hopkins training opportunities and came over to help at Induction Day at USNA. He was fine with the longer obligation, wanted to be a career military doc (and still is).

The current with-dependents BAH monthly rate, an untaxed allowance, in the DC area is $2706, rising to $3312 at the 4- year point when they make O-3.

 

[severn]

At first glance I'm having a hard time figuring out why anyone would choose USUHS over HPSP in order to fund medical school. USUHS appears to require a longer service obligation, and as far as I can tell, the only benefit is being on active duty while in school, but that's mitigated by the generous stipend and 45-day annual ADT that HPSP students get. In addition, if the Air Force information on-line remains accurate, it seems to me that being awarded an HPSP (at least from the Air Force) is easier than being accepted to USUHS.

What am I missing?

... so you're missing a lot in HPSP because your meager stipend only covers the large Domino's pizza and 12 ounce coke. On the other hand, USUHS receives the same Active Duty Pay and benefits as a 2nd Lt/Ensign. So instead of Domino's, maybe switch to Outback/Black Angus, thus leaving a nice impression on your significant other.

 

[franknd]

... so you're missing a lot in HPSP because your meager stipend only covers the large Domino's pizza and 12 ounce coke. On the other hand, USUHS receives the same Active Duty Pay and benefits as a 2nd Lt/Ensign. So instead of Domino's, maybe switch to Outback/Black Angus, thus leaving a nice impression on your significant other.

Maybe it's because I'm intuitively comparing it to ROTC stipend, but HPSP stipend is $2,728/month (10.5 months), then there's the 45 days of ADT. It's not nothing.

 

[franknd]

For people already on AD coming in from a SA or other AD, it provides seamless continuity of benefits - especially untaxed BAH in the DC area, Commissary and Exchange benefits, and no-cost TRICARE healthcare. And - if you have a family or plan to start one, that continuity of benefits is extra important.

We had a USNA sponsor son get into several fine medical schools, but he elected to go to USUHS, as he was getting married in August after graduation, and they planned to start their family within a year. He was able to immediately start his TSP (govt 401K) with his earned income as an O-1, got his single then with-dependents BAH housing allowance at DC-area rate, had full medical and dental coverage for wife and the 2 kids they had while he was at USUHS. He loved the access to senior military doctors and their career mentoring, opportunity to get time on USNS COMFORT, exposure to Johns Hopkins training opportunities and came over to help at Induction Day at USNA. He was fine with the longer obligation, wanted to be a career military doc (and still is).

The current with-dependents BAH monthly rate, an untaxed allowance, in the DC area is $2706, rising to $3312 at the 4- year point when they make O-3.

Yeah, I get why it makes sense for someone coming from AD, particularly, say, if you're already an O-3. Totally get that. As for the 60% coming straight from civilian life, I guess you're balancing the taxable O-1 base pay during four years of med school (which is what you're missing with HPSP since the HPSP stipend seems to basically equate to non-taxable BAH) against the additional service obligation, which seems to net out at 3 additional years + 6 more in the IRR (or 4+4, 5+2, or 7+0).

 

[AROTC Parent]

Yeah, I get why it makes sense for someone coming from AD, particularly, say, if you're already an O-3. Totally get that. As for the 60% coming straight from civilian life, I guess you're balancing the taxable O-1 base pay during four years of med school (which is what you're missing with HPSP since the HPSP stipend seems to basically equate to non-taxable BAH) against the additional service obligation, which seems to net out at 3 additional years + 6 more in the IRR (or 4+4, 5+2, or 7+0).

Ramblings...

For most it doesn't matter USUHS vs HPSP... only 42% of US medical school applicants are accepted anywhere and many are only accepted to a single school. For the best applicants interested in serving that get multiple acceptances - apply to both programs and similar to choosing a service academy or university for ROTC choose based on where you believe you fit and can succeed.

The $2728 HPSP stipend is taxed so it's lower than Bethesda single BAH. Even a single person might have difficulty living off the HPSP stipend in a HCOL city. It can be done but many still have to take out loans to live. HPSP does not cover the medical insurance costs for family members only the service member. Throw in Board Prep, medical board/specialty testing, and licensing costs which are not covered... more loans for HPSP but paid out of salary for USUHS.

Another non financial consideration of HPSP vs USUHS for residency selection - USUHS students rotate at many medical treatment facilities (hospitals) and get more exposure to active duty staff and physicians. HPSP rotate at military hospitals only during their two? ADT's. The evaluations/LORs during HPSP ADT's and USUHS rotations are part of the military residency application.

USUHS graduates are eligible for retirement 'credit' of 4 years (USUHS AD time) once they hit 20+ yrs and retire =24+yrs for retirement pay calculations. HPSP while in medical school is not active duty and not credited similarly.

Any residency greater than 5 years for an HPSP officer incurs additional service obligation beyond the HPSP 4 year obligation. An HPSP officer chosen for a specialty that requires a fellowship (GI, Cardiology, CT Surgery, ...) increases their obligation >4 years unless they wait to specialize as a civilian after their obligation is complete - most medical students don't know what specialty they want to pursue until a few years into medical school. USUHS students extend their obligation too if chosen for fellowship requiring longer specialty training.

I'm not advocating for or against HPSP vs USUHS toward military medicine - it's a personal choice. Choose the best medical school for 'you', the applicant - where are you going to get the best training? Don't apply/attend a medical school without an associated fully functioning hospital system. Many new DO schools don't have established clinical rotations and the training outcomes are poor.

Because you did not indicate the applicant is already obligated via ROTC/Service Academy or that they have a desire to serve above all else - Another option is neither USUHS nor HPSP. Attend a US medical school with loans and commission after completing your specialty of choice. Take the medical officer sign on bonus for active duty and utilize Public Service Loan Forgiveness or become a civilian physician and pay off the loans with the significantly higher income.

 

[franknd]

For most it doesn't matter USUHS vs HPSP... only 42% of US medical school applicants are accepted anywhere and many are only accepted to a single school. For the best applicants interested in serving that get multiple acceptances - apply to both programs and similar to choosing a service academy or university for ROTC choose based on where you believe you fit and can succeed.

Right, by the numbers USUHS appears more difficult to be accepted to than receiving an HPSP offer. From what I have read, if an applicant gets in to any M.D./D.O. program, the applicant stands a very good chance of winning an HPSP; and the Air Force and Army (couldn't find the data for the Navy) automatically offer it with a GPA/MCAT combo somewhat below the admitted profile to USUHS.

The $2728 HPSP stipend is taxed

I didn't know that. I wonder why that is since ROTC stipends are not.

HPSP does not cover the medical insurance costs for family members only the service member.

Yes, I definitely understand the attraction of USUHS/being on AD for prior service and students with dependents. No question.

Because you did not indicate the applicant is already obligated via ROTC/Service Academy

It's a couple of years off yet, but no. And, again, if he were, that would favor USUHS IMO.

Thanks for the detailed response.

 

[USNA_STEM_Prof]

What am I missing?

HPSP often isn't awarded at the beginning of medical school IIRC. Recipients, at least when I was recruiting (2013-2015), were frequently into medical school some number of years, and occasionally even in residency. It's all business in the end, and the service obligations reflect the benefits difference from the perspective of the DoD as I view it.